Claim total
$843.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2011-01-24
- Stop
- 2011-01-24
The parties
- Provider
- provider Elbert Schaefer
- Payer
- payer UnitedHealthcare
Record id
3a86b7c8-d29b-6af3-dd9a-cdaf0a8a9976