Claim total
$1,328.67
base $93.83 · payer covered $1,328.67
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-03-07
- Stop
- 2017-03-07
The parties
- Patient
- patient Jacqui Bess Baumbach
- Provider
- provider Vernon Labadie
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Dual Eligible
Record id
019cda32-2557-7f65-4a86-d95144f815e3