Claim total
$1,185.08
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1998-05-07
- Stop
- 1998-05-07
The parties
- Patient
- patient Ozzie Pasquale Bogisich
- Provider
- provider Jaime Jacobi
- Care site
- care site HENNEPIN COUNTY
Record id
099c86d1-c37a-eaca-9ad7-020d23094103