Claim total
$704.41
base $93.83 · payer covered $563.52
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2012-09-23
- Stop
- 2012-09-23
The parties
- Patient
- patient Elvin Benny Christiansen
- Provider
- provider Elbert Schaefer
- Payer
- payer Medicare
Record id
1cc1c88b-99ff-9af7-2b53-291f39f7529f