Claim total
$229.83
base $93.83 · payer covered $129.83
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2015-02-24
- Stop
- 2015-02-24
The parties
- Patient
- patient An Wenona Rau
- Provider
- provider Anneliese Bradtke
- Payer
- payer Medicaid
Record id
04682680-f77d-0a00-1160-4cf3afd130ac