Claim total
$1,041.77
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-12-25
- Stop
- 2016-12-25
The parties
- Patient
- patient Fernando Wm Schulist
- Provider
- provider Will Leuschke
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Aetna
Record id
0ba4835e-ecc9-876f-fd16-7b89bf12fecd