Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1984-04-16
- Stop
- 1984-04-16
The parties
- Patient
- patient Chung Spinka
- Provider
- provider Georgetta Kohler
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer No insurance
Record id
0453bbfc-4b53-3293-10d3-f366b6719fd8