Claim total
$780.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1984-03-27
- Stop
- 1984-03-27
The parties
- Patient
- patient Mariano Green
- Provider
- provider Nicolas Raynor
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer No insurance
Record id
28193b56-5937-c165-26e9-debc4eb9fe7f