Claim total
$1,608.47
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-04-13
- Stop
- 2025-04-13
The parties
- Patient
- patient Louann Kulas
- Provider
- provider Samantha Schmidt
- Care site
- care site HENNEPIN COUNTY
Record id
2a098ee4-b472-5a9e-76e6-88d0bfdc06ff