Claim total
$906.71
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2005-07-02
- Stop
- 2005-07-02
The parties
- Patient
- patient Cassandra Teofila Stamm
- Provider
- provider Samantha Schmidt
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
39fcdcc4-3c12-057a-d153-f521591894a7