Claim total
$767.69
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2000-03-22
- Stop
- 2000-03-22
The parties
- Patient
- patient Xochitl Bryanna Toy
- Provider
- provider Waneta Boyer
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
379be1b0-73f0-ef08-02b5-59a6a105b9b4