Claim total
$775.00
base $93.83 · payer covered $619.99
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-10-23
- Stop
- 2017-10-23
The parties
- Patient
- patient Alyson Janie Marquardt
- Provider
- provider Avery VonRueden
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicare
Record id
00faac37-85e6-9663-9ac7-a87f3db0cdfc