Claim total
$631.69
base $93.83 · payer covered $505.34
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-07-28
- Stop
- 2021-07-28
The parties
- Patient
- patient Brenna Gricelda Lind
- Provider
- provider Fatimah Schumm
- Payer
- payer Medicare
Record id
0291d14d-46f7-a76b-7864-49d99a163b0f