Claim total
$641.13
base $93.83 · payer covered $591.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1959-05-16
- Stop
- 1959-05-16
The parties
- Patient
- patient Irving Steve Legros
- Provider
- provider Vicente McClure
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
02796652-7893-0df9-7fbd-01fad89db11b