Claim total
$899.40
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-06-27
- Stop
- 2015-06-27
The parties
- Patient
- patient Berta Florencia Colunga
- Provider
- provider Alesha Wilderman
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Humana
Record id
1db706a4-42e5-bfbc-d552-47b616c01145