Claim total
$1,084.10
base $93.83 · payer covered $1,034.10
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1993-10-13
- Stop
- 1993-10-13
The parties
- Patient
- patient Cedrick Heath Rosenbaum
- Provider
- provider Robbi Stark
- Payer
- payer Medicaid
Record id
03eafe4d-23cd-eb61-2a0f-8bd6bf0f74ec