Claim total
$773.83
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2024-06-11
- Stop
- 2024-06-11
The parties
- Provider
- provider Adriene Wisozk
- Care site
- care site TWIN CITIES MEDICAL CLINIC PC
- Payer
- payer Humana
Record id
01552496-8a29-5071-7a34-6794520e9805