Claim total
$1,396.98
base $93.83 · payer covered $1,117.57
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-10-23
- Stop
- 2023-10-23
The parties
- Patient
- patient Elinore Lizeth Crist
- Provider
- provider Magen Mertz
- Payer
- payer Medicare
Record id
1c47d02d-0fef-9635-2801-e452b6115228