Claim total
$772.84
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2000-10-08
- Stop
- 2000-10-08
The parties
- Patient
- patient Debra Lakisha Weimann
- Provider
- provider Garret Mohr
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
26eb4029-b786-3cf8-657c-f64b5b1ff90c