Claim total
$1,088.80
base $93.83 · payer covered $871.04
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2008-02-04
- Stop
- 2008-02-04
The parties
- Patient
- patient Raylene Edris Parisian
- Provider
- provider Magen Mertz
- Payer
- payer Medicare
Record id
298344b3-dd31-0e7f-b6c2-e841ae8b5105