Claim total
$899.40
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1974-09-27
- Stop
- 1974-09-27
The parties
- Patient
- patient Brooks Fred Jones
- Provider
- provider Tim Borer
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
1b22a3c2-c430-b888-f0c1-f67e06a5fe16