Claim total
$1,318.06
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2022-05-06
- Stop
- 2022-05-06
The parties
- Patient
- patient Carolynn Gabriele Zemlak
- Provider
- provider Kanesha Bruen
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
032e4024-8595-f612-4b49-b682544c931d