Claim total
$843.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2001-02-13
- Stop
- 2001-02-13
The parties
- Patient
- patient Dwain Lubowitz
- Provider
- provider Winfred Gaylord
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
161a011f-815c-6571-a0de-08f9fbccc82f