Claim total
$4,420.36
base $93.83 · payer covered $3,536.28
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-08-06
- Stop
- 2016-08-06
The parties
- Patient
- patient Porfirio West
- Provider
- provider Anneliese Bradtke
- Payer
- payer Medicare
Record id
05880a71-6004-727f-17c8-ec027451ceaf