Claim total
$973.34
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-04-10
- Stop
- 2024-04-10
The parties
- Patient
- patient Rigoberto Kelley Wyman
- Provider
- provider Tyrone Stracke
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer UnitedHealthcare
Record id
07ebb648-88e3-490f-f89b-ae4964ecc310