Claim total
$843.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1974-08-14
- Stop
- 1974-08-14
The parties
- Patient
- patient Gaylene Adell Reynolds
- Provider
- provider Jeanie Senger
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
34c15c13-e4f6-1b19-3dc9-dcaeec259344