Claim total
$838.28
base $93.83 · payer covered $484.21
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-02-25
- Stop
- 2017-02-25
The parties
- Provider
- provider Bradley Terry
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicare
Record id
049095f1-5bc1-9ce0-f39f-97b563d8714d