Claim total
$1,258.42
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-12-20
- Stop
- 2018-12-20
The parties
- Patient
- patient Maryland Hermine Ryan
- Provider
- provider Waneta Boyer
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Aetna
Record id
2594c568-de7d-2084-88f3-7e422c29a1b3