Claim total
$985.80
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2003-02-09
- Stop
- 2003-02-09
The parties
- Patient
- patient Alline Tilda Daugherty
- Provider
- provider Brynn Jones
- Care site
- care site HENNEPIN COUNTY
Record id
169ee930-05cf-aa0a-1020-dd9e08aba678