Claim total
$980.65
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1986-07-19
- Stop
- 1986-07-19
The parties
- Patient
- patient Maynard Omer Metz
- Provider
- provider Will Leuschke
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer No insurance
Record id
340f3309-d5f5-88b6-5203-1a93181c5bd3