Claim total
$1,620.25
base $93.83 · payer covered $1,109.79
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2013-09-30
- Stop
- 2013-09-30
The parties
- Patient
- patient Alyson Janie Marquardt
- Provider
- provider Ines Kautzer
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicare
Record id
00faac37-85e6-9663-9447-eae1dde9f202