Claim total
$980.65
base $93.83 · payer covered $641.32
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2009-01-16
- Stop
- 2009-01-16
The parties
- Patient
- patient Carolann Vernia Kunze
- Provider
- provider Alfred Moen
- Care site
- care site ADVANCED MEDICAL CENTER INC
- Payer
- payer Medicare
Record id
283a3827-ad30-1b6b-a4b0-50ed5629ae26