Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2004-05-17
- Stop
- 2004-05-17
The parties
- Patient
- patient Cleo Watsica
- Provider
- provider Asha Ferry
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
017647b2-914f-2bdf-1dc4-b060a9c7cb97