Claim total
$4,543.86
base $93.83 · payer covered $4,543.86
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1996-02-21
- Stop
- 1996-02-21
The parties
- Patient
- patient Perla Roseanne Herzog
- Provider
- provider Elbert Schaefer
- Payer
- payer Medicare
Record id
1e76911d-0c60-0943-017e-ac244ebc880e