Claim total
$1,503.33
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1999-11-09
- Stop
- 1999-11-09
The parties
- Patient
- patient Rafael Marcos Jaramillo
- Provider
- provider Cheri Mitchell
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
23c6ce6e-bfd3-c3e8-3c4d-0e85c940ba28