Claim total
$980.65
base $93.83 · payer covered $598.11
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-11-04
- Stop
- 2019-11-04
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-eb8a-d340c9d59c3a