Claim total
$900.62
base $93.83 · payer covered $720.48
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-11-05
- Stop
- 2015-11-05
The parties
- Provider
- provider Elbert Schaefer
- Payer
- payer Medicare
Record id
0366d403-b006-0b76-19dd-74945dbdaa04