Claim total
$1,618.72
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2002-05-22
- Stop
- 2002-05-22
The parties
- Patient
- patient Abbie Kulas
- Provider
- provider Niki O'Kon
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
377e9575-a2e9-6ea3-499d-83b90a4d0821