Claim total
$3,973.46
base $93.83 · payer covered $3,178.76
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-07-26
- Stop
- 2014-07-26
The parties
- Patient
- patient Porfirio West
- Provider
- provider Julene Lemke
- Payer
- payer Medicare
Record id
05880a71-6004-727f-efbe-d1d1aae98256