Claim total
$1,321.36
base $93.83 · payer covered $873.80
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1996-07-23
- Stop
- 1996-07-23
The parties
- Patient
- patient Melinda Ines Koelpin
- Provider
- provider Florentino Boehm
- Payer
- payer Medicare
Record id
26d1b146-99fe-e0df-ad63-5f459f77df45