Claim total
$641.13
base $93.83 · payer covered $326.50
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1972-02-05
- Stop
- 1972-02-05
The parties
- Provider
- provider Bradley Terry
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicare
Record id
049095f1-5bc1-9ce0-db73-e13cef1ed331