Claim total
$1,132.83
base $93.83 · payer covered $731.27
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-12-11
- Stop
- 2024-12-11
The parties
- Patient
- patient Shon Cesar Ebert
- Provider
- provider Remona Sanford
- Payer
- payer Medicare
Record id
03d8f92f-53db-d7af-b534-abf4736aa400