Claim total
$917.97
base $93.83 · payer covered $548.75
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-10-27
- Stop
- 2021-10-27
The parties
- Patient
- patient Kim Edmundo Rolfson
- Provider
- provider Elbert Schaefer
- Payer
- payer Medicare
Record id
03d7ab8f-b989-4d49-5aee-07fcf0424d14