Claim total
$906.71
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1991-07-13
- Stop
- 1991-07-13
The parties
- Patient
- patient Tatiana Mozella Doyle
- Provider
- provider Olin Mosciski
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Humana
Record id
24379d93-202b-0dcf-7963-771760183ee9