Claim total
$910.06
base $93.83 · payer covered $4.11
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-06-01
- Stop
- 2019-06-01
The parties
- Patient
- patient Heriberto Orval Feest
- Provider
- provider Thomasine Balistreri
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer UnitedHealthcare
Record id
04dd6dd9-2faa-05da-2877-961cd695765d