Claim total
$775.00
base $93.83 · payer covered $433.59
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-04-01
- Stop
- 2023-04-01
The parties
- Provider
- provider Bradley Terry
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicare
Record id
049095f1-5bc1-9ce0-5427-4cc5bed349b4