Claim total
$1,457.08
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-10-28
- Stop
- 2019-10-28
The parties
- Patient
- patient Eliseo Laverne Nader
- Provider
- provider Niki O'Kon
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Humana
Record id
2c167999-289d-95fa-239c-5bee667eedb7