Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-04-22
- Stop
- 2017-04-23
The parties
- Patient
- patient Latoya Serina Howell
- Provider
- provider Brynn Jones
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Humana
Record id
01a84ea8-c5e2-54d4-d756-17e88c289ae5