Claim total
$972.12
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-07-29
- Stop
- 2018-07-29
The parties
- Patient
- patient Cheri Jonna Gutmann
- Provider
- provider Samantha Schmidt
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer UnitedHealthcare
Record id
22220d10-33d3-225a-71f4-9c5674cd162f