Claim total
$641.13
base $93.83 · payer covered $491.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1975-08-27
- Stop
- 1975-08-27
The parties
- Patient
- patient Cedrick Heath Rosenbaum
- Provider
- provider Martha Ledner
- Payer
- payer Medicaid
Record id
03eafe4d-23cd-eb61-d5ad-3f611ae52508