Claim total
$1,123.02
base $93.83 · payer covered $713.56
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2004-05-03
- Stop
- 2004-05-03
The parties
- Patient
- patient Lauralee Carline Mueller
- Provider
- provider Abram Ullrich
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer Medicare
Record id
1c820c1e-9848-a5a8-d426-44de8d088970