Claim total
$973.34
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-06-20
- Stop
- 2018-06-20
The parties
- Patient
- patient Nona Samara Gleichner
- Provider
- provider Thomasine Balistreri
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Humana
Record id
0042ca65-dd9d-7221-cdc0-8e900c66014f