Claim total
$840.41
base $93.83 · payer covered $690.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2005-03-01
- Stop
- 2005-03-01
The parties
- Patient
- patient Rocio Margarita Alcaraz
- Provider
- provider Horacio Baumbach
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
0274bb53-c777-eb96-cc8c-f91ef40d8bbc