Claim total
$1,062.94
base $93.83 · payer covered $663.94
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-10-29
- Stop
- 2018-10-29
The parties
- Patient
- patient Alyson Janie Marquardt
- Provider
- provider Garret Mohr
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicare
Record id
00faac37-85e6-9663-16ba-ed4cad0f164c