Claim total
$1,072.83
base $93.83 · payer covered $972.83
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-07-12
- Stop
- 2017-07-12
The parties
- Provider
- provider Morgan Crona
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
010d736c-d81f-3cd7-b860-744acaa2dc6b