Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1999-08-28
- Stop
- 1999-08-28
The parties
- Patient
- patient Hosea Sterling MacGyver
- Provider
- provider Deloras Lesch
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
06447c96-5e71-8652-8385-7f3631546b70