Claim total
$775.00
base $93.83 · payer covered $511.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2007-07-04
- Stop
- 2007-07-04
The parties
- Patient
- patient Jone Rae Hilpert
- Provider
- provider Julene Lemke
- Payer
- payer Medicare
Record id
06668488-9bc5-0bda-86ad-1adcad244eef