Claim total
$1,482.61
base $93.83 · payer covered $1,482.61
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2020-03-30
- Stop
- 2020-03-30
The parties
- Patient
- patient Lawrence Daugherty
- Provider
- provider Niki O'Kon
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Dual Eligible
Record id
09df0285-fddb-28fc-70ce-a66e0714a824