Claim total
$973.34
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1979-08-01
- Stop
- 1979-08-01
The parties
- Patient
- patient Hans Marion Kuvalis
- Provider
- provider Niki O'Kon
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
107d0674-dc76-cfa0-f95a-f6deceba0102