Claim total
$1,112.36
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1985-01-14
- Stop
- 1985-01-14
The parties
- Patient
- patient Markita Hahn
- Provider
- provider Georgetta Kohler
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer No insurance
Record id
073a6492-3457-ad14-8b54-6773caa7f47c