Claim total
$1,527.01
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1996-07-02
- Stop
- 1996-07-02
The parties
- Patient
- patient Jonie Beckie Crooks
- Provider
- provider Benjamín Montoya
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
2ff943bc-7162-f8cc-3442-0508353a1183