Claim total
$843.43
base $93.83 · payer covered $693.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2003-05-22
- Stop
- 2003-05-22
The parties
- Patient
- patient Ilse Tynisha Feest
- Provider
- provider Georgetta Kohler
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
06d55723-a17e-fb1b-7920-0645debaaf0f