Claim total
$840.41
base $93.83 · payer covered $790.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2004-01-14
- Stop
- 2004-01-14
The parties
- Patient
- patient Deirdre Shannon Hayes
- Provider
- provider Jeanie Senger
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
0194ec83-bb8c-3a71-c511-3df48b8dc4e2