Claim total
$5,638.21
base $93.83 · payer covered $796.75
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-08-16
- Stop
- 2014-08-16
The parties
- Patient
- patient Willy Oscar Renner
- Provider
- provider Garret Mohr
- Care site
- care site NORTH MEMORIAL HEALTH CARE
Record id
2efab6af-c1c3-5620-02de-b8e761a91276