Claim total
$830.97
base $93.83 · payer covered $483.40
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2020-05-11
- Stop
- 2020-05-11
The parties
- Patient
- patient Chung Spinka
- Provider
- provider Ines Kautzer
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicare
Record id
0453bbfc-4b53-3293-3343-1f360151f211