Claim total
$1,191.45
base $93.83 · payer covered $769.09
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-03-25
- Stop
- 2014-03-25
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
24acc780-1907-3987-8ee9-2ce20f5b7941