Claim total
$1,042.99
base $93.83 · payer covered $1,042.99
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-04-16
- Stop
- 2025-04-16
The parties
- Patient
- patient Cedrick Heath Rosenbaum
- Provider
- provider Sylvester Bartoletti
- Payer
- payer Dual Eligible
Record id
03eafe4d-23cd-eb61-4a80-d6fc87410e58