Claim total
$1,115.71
base $93.83 · payer covered $1,115.71
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-02-12
- Stop
- 2014-02-12
The parties
- Patient
- patient Cedrick Heath Rosenbaum
- Provider
- provider Joetta Crooks
- Payer
- payer Dual Eligible
Record id
03eafe4d-23cd-eb61-adb4-3ab1efa6c3e5