Claim total
$1,242.27
base $93.83 · payer covered $1,242.27
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-02-24
- Stop
- 2016-02-24
The parties
- Patient
- patient Cedrick Heath Rosenbaum
- Provider
- provider Martha Ledner
- Payer
- payer Dual Eligible
Record id
03eafe4d-23cd-eb61-370e-bb440e58179c