Claim total
$1,251.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2005-07-06
- Stop
- 2005-07-06
The parties
- Patient
- patient Valentine Samuel Gleason
- Provider
- provider Tim Borer
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Humana
Record id
29386bfb-6a3a-9735-0326-3cd374d37dc1