Claim total
$910.06
base $93.83 · payer covered $614.36
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2003-11-07
- Stop
- 2003-11-07
The parties
- Provider
- provider Sage Schiller
- Care site
- care site SAMA HEALTH CARE
- Payer
- payer Medicare
Record id
2c186144-fcb7-debf-f284-1c5be14c3bd9