Claim total
$641.13
base $93.83 · payer covered $491.13
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1995-05-25
- Stop
- 1995-05-25
The parties
- Patient
- patient Johnny Mattie Skiles
- Provider
- provider Jamison Rau
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
01f72a06-0d81-377c-8a85-b5248e6e2bd7