Claim total
$1,663.01
base $93.83 · payer covered $1,144.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-04-03
- Stop
- 2023-04-03
The parties
- Patient
- patient Rosaria Golden Bashirian
- Provider
- provider Hazel Effertz
- Payer
- payer Medicare
Record id
015dd051-d88b-0f3d-2eda-834ae6800e75