Claim total
$1,590.29
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1998-01-22
- Stop
- 1998-01-22
The parties
- Patient
- patient Slyvia Kymberly Dibbert
- Provider
- provider Vicente McClure
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
1263b62e-c014-f602-0dde-c89e139a2ae8