Claim total
$1,361.30
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1983-04-11
- Stop
- 1983-04-11
The parties
- Patient
- patient Jame Francis Spencer
- Provider
- provider Shoshana Runolfsdottir
- Care site
- care site HENNEPIN COUNTY
Record id
1e486d91-3b1b-3077-370a-50e87f4c8c89