Claim total
$767.69
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-11-05
- Stop
- 2015-11-05
The parties
- Patient
- patient Son Lesley Hauck
- Provider
- provider Alesha Wilderman
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
01d28099-b492-968b-b8a1-62ec2739b249