Claim total
$775.00
base $93.83 · payer covered $456.60
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2004-01-20
- Stop
- 2004-01-20
The parties
- Patient
- patient Roy Billie Ankunding
- Provider
- provider Dan Leuschke
- Care site
- care site WELLNESS CENTERS, PLLC
- Payer
- payer Medicare
Record id
2cc69e6e-eaec-c9c0-92c9-edc59c258f5a