Claim total
$780.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1992-11-20
- Stop
- 1992-11-20
The parties
- Patient
- patient Ali Darron Greenfelder
- Provider
- provider Garret Mohr
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
08ba36d2-4051-3238-5a14-d86361f25bd4