Claim total
$979.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1986-06-18
- Stop
- 1986-06-18
The parties
- Patient
- patient Felipe Dwain Keebler
- Provider
- provider Winfred Gaylord
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Humana
Record id
02f04cf4-122a-e8d3-8b7d-1fa0e3a7ad93