Claim total
$505.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1941-12-30
- Stop
- 1941-12-30
The parties
- Patient
- patient Astrid Doria Dach
- Provider
- provider Danilo Haley
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Humana
Record id
02e7d6ac-dd81-002b-0b54-18c4a0a17cc8