Claim total
$973.34
base $93.83 · payer covered $778.66
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1991-11-20
- Stop
- 1991-11-20
The parties
- Patient
- patient Mauro Long Emmerich
- Provider
- provider Deloras Lesch
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicare
Record id
23076cc7-987a-7400-4c8e-1bd712653609