Claim total
$917.37
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2012-12-15
- Stop
- 2012-12-15
The parties
- Patient
- patient Dane Randolph Lynch
- Provider
- provider Elbert Schaefer
- Payer
- payer UnitedHealthcare
Record id
1632b7b9-383c-c840-1ac5-4168522aaaff