Claim total
$846.78
base $93.83 · payer covered $796.78
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2001-09-10
- Stop
- 2001-09-10
The parties
- Patient
- patient Columbus Kerluke
- Provider
- provider Ines Kautzer
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Medicaid
Record id
38f2e58f-5d08-f8a7-9271-78095386a7fe