Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1994-12-24
- Stop
- 1994-12-24
The parties
- Provider
- provider Bradley Terry
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
049095f1-5bc1-9ce0-e7cb-c0d9209276d1