Claim total
$916.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1997-01-14
- Stop
- 1997-01-14
The parties
- Patient
- patient Hyacinth Nida Walter
- Provider
- provider Britt Sipes
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
319b8f7c-9751-3ab0-5271-597f0dcaae90