Claim total
$1,091.09
base $93.83 · payer covered $1,091.09
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-02-21
- Stop
- 2015-02-21
The parties
- Patient
- patient Alvin Tracy Morar
- Provider
- provider Trevor Williamson
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
00df058f-9df4-4d69-9580-a7a72c14fb05