Claim total
$1,530.58
base $93.83 · payer covered $1,041.17
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2020-10-23
- Stop
- 2020-10-23
The parties
- Patient
- patient Maryjo Amal Goldner
- Provider
- provider Tyson Kautzer
- Care site
- care site THE FAMILY PARTNERSHIP
- Payer
- payer Medicare
Record id
2ed77eab-3571-a72d-4d98-da740a76d11a