Claim total
$780.15
base $93.83 · payer covered $780.15
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1993-09-29
- Stop
- 1993-09-29
The parties
- Patient
- patient Nona Samara Gleichner
- Provider
- provider Vina Durgan
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Humana
Record id
0042ca65-dd9d-7221-258d-df7dd8236247