Claim total
$1,384.64
base $93.83 · payer covered $1,384.64
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2026-04-22
- Stop
- 2026-04-22
The parties
- Patient
- patient Cedrick Heath Rosenbaum
- Provider
- provider Robbi Stark
- Payer
- payer Dual Eligible
Record id
03eafe4d-23cd-eb61-006d-4cf5ecf6672a