Claim total
$767.69
base $93.83 · payer covered $617.69
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1998-11-11
- Stop
- 1998-11-11
The parties
- Patient
- patient Cedrick Heath Rosenbaum
- Provider
- provider Martha Ledner
- Payer
- payer Medicaid
Record id
03eafe4d-23cd-eb61-1659-9157d19aa110