Claim total
$840.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2004-08-28
- Stop
- 2004-08-28
The parties
- Patient
- patient Leslee Christiansen
- Provider
- provider Luanna Bogan
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
01280686-ae2e-42f0-1c81-627d3a78acc1