Claim total
$1,321.36
base $93.83 · payer covered $1,057.08
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-01-20
- Stop
- 2024-01-20
The parties
- Patient
- patient Gonzalo Goodwin
- Provider
- provider Garret Mohr
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicare
Record id
1b095863-7386-17e5-f46b-5b48399bceea