Claim total
$906.71
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1999-07-12
- Stop
- 1999-07-12
The parties
- Patient
- patient Alyson Janie Marquardt
- Provider
- provider Altagracia Rippin
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer No insurance
Record id
00faac37-85e6-9663-cbdc-bf012809e412