Claim total
$772.84
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1990-05-05
- Stop
- 1990-05-05
The parties
- Patient
- patient Brenna Myrtie VonRueden
- Provider
- provider Garret Mohr
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer No insurance
Record id
248c77f0-90ce-d659-80a3-8eee0e77e4f2