Claim total
$704.41
base $93.83 · payer covered $554.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1988-09-14
- Stop
- 1988-09-14
The parties
- Patient
- patient Cedrick Heath Rosenbaum
- Provider
- provider Robbi Stark
- Payer
- payer Medicaid
Record id
03eafe4d-23cd-eb61-48ad-bc286eff16ea