Claim total
$8,103.39
base $93.83 · payer covered $6,313.40
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2011-09-28
- Stop
- 2011-09-28
The parties
- Patient
- patient Shon Cesar Ebert
- Provider
- provider Remona Sanford
- Payer
- payer Medicare
Record id
03d8f92f-53db-d7af-6913-e6c32d5a3487