Claim total
$980.65
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1983-08-26
- Stop
- 1983-08-26
The parties
- Patient
- patient Carolann Vernia Kunze
- Provider
- provider Jack Grimes
- Care site
- care site ADVANCED MEDICAL CENTER INC
- Payer
- payer Humana
Record id
283a3827-ad30-1b6b-8e38-c4e443c7abdc