Claim total
$1,112.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-09-08
- Stop
- 2014-09-08
The parties
- Patient
- patient Albert Gaylord Kiehn
- Provider
- provider Benjamín Montoya
- Care site
- care site HENNEPIN COUNTY
Record id
03865fba-8cf7-44f6-d5db-3abc75d24454