Claim total
$711.72
base $93.83 · payer covered $382.97
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-11-15
- Stop
- 2021-11-15
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-f8d5-e61a3facaa6a