Claim total
$780.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-05-21
- Stop
- 2024-05-21
The parties
- Patient
- patient Garrett Lon Kertzmann
- Provider
- provider Vina Durgan
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Humana
Record id
0866e065-67e0-4dd0-542c-825b04c8ee27