Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-03-02
- Stop
- 2017-03-02
The parties
- Patient
- patient Rudolph Bud Batz
- Provider
- provider Maryam Wolf
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer No insurance
Record id
02c734eb-6a05-b133-9c4a-ff4a41f79b03