Claim total
$767.69
base $93.83 · payer covered $430.24
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-10-30
- Stop
- 2014-10-30
The parties
- Provider
- provider Elbert Schaefer
- Payer
- payer Medicare
Record id
0366d403-b006-0b76-3b68-58e4f913f240