Claim total
$641.13
base $93.83 · payer covered $491.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1973-09-15
- Stop
- 1973-09-15
The parties
- Patient
- patient Berry Aaron Deckow
- Provider
- provider Anneliese Bradtke
- Payer
- payer Medicaid
Record id
03959b6c-660d-eecd-c516-62a898c41ff8