Claim total
$867.31
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-09-11
- Stop
- 2017-09-11
The parties
- Patient
- patient Albert Gaylord Kiehn
- Provider
- provider Benjamín Montoya
- Care site
- care site HENNEPIN COUNTY
Record id
03865fba-8cf7-44f6-bac5-7564a7826112