Claim total
$840.41
base $93.83 · payer covered $840.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-04-10
- Stop
- 2024-04-10
The parties
- Patient
- patient Cedrick Heath Rosenbaum
- Provider
- provider Sylvester Bartoletti
- Payer
- payer Dual Eligible
Record id
03eafe4d-23cd-eb61-4b66-1ea71e03b838