Claim total
$641.13
base $93.83 · payer covered $512.90
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-05-03
- Stop
- 2014-05-03
The parties
- Patient
- patient Heriberto Orval Feest
- Provider
- provider Vina Durgan
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer UnitedHealthcare
Record id
04dd6dd9-2faa-05da-1cb1-30ed14744413