Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2012-02-01
- Stop
- 2012-02-01
The parties
- Patient
- patient Vicky Alvera Gulgowski
- Provider
- provider Adriene Wisozk
- Care site
- care site TWIN CITIES MEDICAL CLINIC PC
Record id
25ad8aae-d2b9-f615-e158-6441ca03faa0