Claim total
$1,623.17
base $93.83 · payer covered $350.50
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2008-09-06
- Stop
- 2008-09-06
The parties
- Provider
- provider Brynn Jones
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer UnitedHealthcare
Record id
1ebab170-8a1d-2e20-2a1c-b2948df31f5d