Claim total
$868.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1992-09-23
- Stop
- 1992-09-23
The parties
- Patient
- patient Nona Samara Gleichner
- Provider
- provider Vina Durgan
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Humana
Record id
0042ca65-dd9d-7221-8da0-bbee5a65d705