Claim total
$980.65
base $93.83 · payer covered $598.11
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2020-11-09
- Stop
- 2020-11-09
The parties
- Patient
- patient Alyson Janie Marquardt
- Provider
- provider Altagracia Rippin
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicare
Record id
00faac37-85e6-9663-c52e-1ef60a732808