Claim total
$704.41
base $93.83 · payer covered $377.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-07-01
- Stop
- 2023-07-01
The parties
- Patient
- patient Santo Quentin Mueller
- Provider
- provider Jaime Jacobi
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicare
Record id
01845754-7d83-d7eb-489e-3e478d42db95