Claim total
$1,123.02
base $93.83 · payer covered $712.79
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-04-06
- Stop
- 2024-04-06
The parties
- Patient
- patient Jeremy Gregory Jacobson
- Provider
- provider Randee Sawayn
- Payer
- payer Medicare
Record id
04f9baea-0c64-12b2-5a67-46b19668a511