Claim total
$1,205.67
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2004-04-25
- Stop
- 2004-04-25
The parties
- Patient
- patient Isaac Vernon Marvin
- Provider
- provider Jeanie Senger
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
007e08f5-37d5-91e8-67c7-371ec22bf2e5