Claim total
$1,233.86
base $93.83 · payer covered $1,233.86
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2012-02-11
- Stop
- 2012-02-11
The parties
- Patient
- patient Lacy Schumm
- Provider
- provider Andria Spinka
- Payer
- payer Dual Eligible
Record id
1b98fd26-00a1-c39a-f7dd-9b5bcb48d5af