Claim total
$843.43
base $93.83 · payer covered $488.34
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1995-08-07
- Stop
- 1995-08-07
The parties
- Patient
- patient Kathy Adelaide Pollich
- Provider
- provider Jared Berge
- Payer
- payer Medicare
Record id
35bae7db-0bec-c432-2756-a83c62916791