Claim total
$767.69
base $93.83 · payer covered $667.69
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2020-07-03
- Stop
- 2020-07-03
The parties
- Patient
- patient Lee Scot Rosenbaum
- Provider
- provider Fatimah Schumm
- Payer
- payer Medicaid
Record id
027e2621-860b-6019-ff74-aafc7ae821d2