Claim total
$830.97
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2012-11-29
- Stop
- 2012-11-29
The parties
- Patient
- patient Elisabeth Gleason
- Provider
- provider Alesha Wilderman
- Care site
- care site HENNEPIN COUNTY
Record id
2687fd40-e7a6-0ada-12d9-5777ba99691b