Claim total
$846.78
base $93.83 · payer covered $796.78
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2003-05-30
- Stop
- 2003-05-30
The parties
- Patient
- patient Lee Scot Rosenbaum
- Provider
- provider Sherwood Nicolas
- Payer
- payer Medicaid
Record id
027e2621-860b-6019-6a85-473f4c4851fe