Claim total
$775.00
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2007-02-26
- Stop
- 2007-02-26
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-4b53-3293-3889-24998330725b