Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2002-12-13
- Stop
- 2002-12-13
The parties
- Patient
- patient Luba Aurora Lind
- Provider
- provider Hope Wisoky
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Humana
Record id
3ac473f7-cf22-bcad-c5bf-a70e6e991090