Claim total
$838.28
base $93.83 · payer covered $788.28
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1977-06-18
- Stop
- 1977-06-18
The parties
- Provider
- provider Georgetta Kohler
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
2d46927f-3540-85ed-908f-d262c2d99eab