Claim total
$1,457.36
base $93.83 · payer covered $984.16
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2002-01-15
- Stop
- 2002-01-15
The parties
- Patient
- patient Evan Daniel Ziemann
- Provider
- provider Leonardo Lindgren
- Care site
- care site LIFE WELLNESS CENTER EAGAN PA
- Payer
- payer Medicare
Record id
24acc780-1907-3987-7d80-3544641c5e55