Claim total
$1,077.59
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2011-05-30
- Stop
- 2011-05-30
The parties
- Patient
- patient Cleo Watsica
- Provider
- provider Marilyn Gleichner
- Care site
- care site HENNEPIN COUNTY
Record id
017647b2-914f-2bdf-e89e-72df0e49032f