Claim total
$848.31
base $93.83 · payer covered $798.31
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2002-12-04
- Stop
- 2002-12-04
The parties
- Patient
- patient Cedrick Heath Rosenbaum
- Provider
- provider Sylvester Bartoletti
- Payer
- payer Medicaid
Record id
03eafe4d-23cd-eb61-ab41-31062ca7994e