Claim total
$976.41
base $93.83 · payer covered $926.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1996-10-22
- Stop
- 1996-10-22
The parties
- Patient
- patient Jacqui Bess Baumbach
- Provider
- provider Britt Sipes
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
019cda32-2557-7f65-f4ac-2901ea3cb33b