Claim total
$843.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1973-01-20
- Stop
- 1973-01-20
The parties
- Patient
- patient Winnie Laurie Jones
- Provider
- provider Adriene Wisozk
- Care site
- care site TWIN CITIES MEDICAL CLINIC PC
- Payer
- payer No insurance
Record id
25a3e01f-d541-1d30-3dce-b27d456b5059