Claim total
$910.06
base $93.83 · payer covered $760.06
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1994-10-15
- Stop
- 1994-10-15
The parties
- Patient
- patient Elbert Rod Lemke
- Provider
- provider Ignacio Paredes
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
039e51d1-c563-811d-4556-4a48698f2205