Claim total
$505.13
base $93.83 · payer covered $505.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2007-06-20
- Stop
- 2007-06-20
The parties
- Provider
- provider Morgan Crona
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
010d736c-d81f-3cd7-5bff-f162e8340fa4