Claim total
$866.22
base $93.83 · payer covered $692.97
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-10-02
- Stop
- 2014-10-02
The parties
- Patient
- patient Lamar Mark Connelly
- Provider
- provider Anneliese Bradtke
- Payer
- payer Medicare
Record id
050746ba-be7e-c592-0e5f-d4daaf913425