Claim total
$1,048.34
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-06-17
- Stop
- 2014-06-17
The parties
- Patient
- patient Ellyn Rosalyn Buckridge
- Provider
- provider Morgan Crona
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer UnitedHealthcare
Record id
30b4f96d-c533-f7b3-38ae-0512aca05111