Claim total
$1,497.92
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-10-24
- Stop
- 2024-10-24
The parties
- Patient
- patient Karina Ziemann
- Provider
- provider Nicolas Raynor
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer No insurance
Record id
35b353dd-402b-571a-8d37-d8dfeb94390e