Claim total
$910.06
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2001-07-23
- Stop
- 2001-07-23
The parties
- Patient
- patient Alyson Janie Marquardt
- Provider
- provider Ines Kautzer
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer No insurance
Record id
00faac37-85e6-9663-7234-89e648df2fd7