Claim total
$644.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1937-04-03
- Stop
- 1937-04-03
The parties
- Patient
- patient Luigi Ezekiel Stehr
- Provider
- provider Shoshana Runolfsdottir
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
0f90eec3-ef36-aefd-1436-bda234b7cf0e