Claim total
$767.69
base $93.83 · payer covered $767.69
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2022-04-02
- Stop
- 2022-04-02
The parties
- Patient
- patient Alvin Tracy Morar
- Provider
- provider Britt Sipes
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
00df058f-9df4-4d69-ffbc-2faba185ad9f