Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2013-04-10
- Stop
- 2013-04-10
The parties
- Patient
- patient Lincoln Reyes Hansen
- Provider
- provider Miki Kirlin
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Humana
Record id
036e82a1-5d34-0b1d-cbf9-9c0c6895a26e