Claim total
$711.72
base $93.83 · payer covered $561.72
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1990-05-17
- Stop
- 1990-05-17
The parties
- Patient
- patient Lamar Mark Connelly
- Provider
- provider Anneliese Bradtke
- Payer
- payer Medicaid
Record id
050746ba-be7e-c592-f089-c2cb5a05c98d