Claim total
$1,516.03
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2002-03-19
- Stop
- 2002-03-19
The parties
- Patient
- patient Eliz Gwendolyn Gulgowski
- Provider
- provider Thomasine Balistreri
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
1d6daf34-91f6-0901-e05b-e42a4e170f8c