Claim total
$1,705.72
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1997-02-17
- Stop
- 1997-02-17
The parties
- Patient
- patient Chung Spinka
- Provider
- provider Ines Kautzer
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer No insurance
Record id
0453bbfc-4b53-3293-6de9-b3d5895becc3