Claim total
$1,221.07
base $93.83 · payer covered $1,221.07
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-03-04
- Stop
- 2017-03-04
The parties
- Patient
- patient Alvin Tracy Morar
- Provider
- provider Britt Sipes
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
00df058f-9df4-4d69-e590-a3d9ab05f75b