Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2009-10-29
- Stop
- 2009-10-29
The parties
- Patient
- patient Son Lesley Hauck
- Provider
- provider Danilo Haley
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
01d28099-b492-968b-49ce-938f43bbbfc2