Claim total
$993.11
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2004-02-22
- Stop
- 2004-02-22
The parties
- Patient
- patient Bella Mackenzie Collier
- Provider
- provider Alesha Wilderman
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Humana
Record id
287b8294-4925-88c5-65cc-67b766b36fea