Claim total
$772.84
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1975-07-11
- Stop
- 1975-07-11
The parties
- Patient
- patient Carolann Vernia Kunze
- Provider
- provider Alfred Moen
- Care site
- care site ADVANCED MEDICAL CENTER INC
- Payer
- payer Humana
Record id
283a3827-ad30-1b6b-7b19-d906f5f89e28