Claim total
$1,117.19
base $93.83 · payer covered $967.19
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1992-10-07
- Stop
- 1992-10-07
The parties
- Patient
- patient Cedrick Heath Rosenbaum
- Provider
- provider Sylvester Bartoletti
- Payer
- payer Medicaid
Record id
03eafe4d-23cd-eb61-b363-9e5fcaf7731b