Claim total
$1,275.39
base $93.83 · payer covered $1,020.30
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2009-05-07
- Stop
- 2009-05-07
The parties
- Patient
- patient Reginald Nicholas Torp
- Provider
- provider Jaime Jacobi
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicare
Record id
30569de9-7593-beca-a1a8-c604aa5fc707