Claim total
$1,054.17
base $93.83 · payer covered $656.93
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-03-03
- Stop
- 2018-03-03
The parties
- Provider
- provider Bradley Terry
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicare
Record id
049095f1-5bc1-9ce0-1a0d-09b92301cbab