Claim total
$1,101.05
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1995-02-13
- Stop
- 1995-02-13
The parties
- Patient
- patient Chung Spinka
- Provider
- provider Kasi Schamberger
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer No insurance
Record id
0453bbfc-4b53-3293-7819-f9fd0cc49aa5