Claim total
$840.41
base $93.83 · payer covered $740.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2026-04-17
- Stop
- 2026-04-17
The parties
- Patient
- patient Lee Scot Rosenbaum
- Provider
- provider Fatimah Schumm
- Payer
- payer Medicaid
Record id
027e2621-860b-6019-f11e-5ab9048fd48c