Claim total
$1,109.34
base $93.83 · payer covered $887.46
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-06-03
- Stop
- 2024-06-03
The parties
- Patient
- patient Chung Spinka
- Provider
- provider Avery VonRueden
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicare
Record id
0453bbfc-4b53-3293-00bf-ba173c620921