Claim total
$861.55
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2012-09-22
- Stop
- 2012-09-22
The parties
- Patient
- patient Arlen Schamberger
- Provider
- provider Olin Mosciski
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
01ee9e96-5701-e5d2-04e9-8160769f924e