Claim total
$973.34
base $93.83 · payer covered $778.66
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2011-06-29
- Stop
- 2011-06-29
The parties
- Provider
- provider Randee Sawayn
- Payer
- payer Medicare
Record id
2c592f19-912d-3aa0-108d-a369b639ebaf