Claim total
$846.78
base $93.83 · payer covered $696.78
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1962-05-24
- Stop
- 1962-05-24
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-fad9-ccee9b0f1ba1