Claim total
$775.00
base $93.83 · payer covered $440.40
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2020-11-18
- Stop
- 2020-11-18
The parties
- Patient
- patient Shon Cesar Ebert
- Provider
- provider Remona Sanford
- Payer
- payer Medicare
Record id
03d8f92f-53db-d7af-0ac4-b8a8b7d877d4