Claim total
$568.41
base $93.83 · payer covered $454.72
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-11-10
- Stop
- 2016-11-10
The parties
- Provider
- provider Elbert Schaefer
- Payer
- payer Medicare
Record id
0366d403-b006-0b76-2f1f-1760183d438a