Claim total
$932.61
base $93.83 · payer covered $932.61
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2013-04-02
- Stop
- 2013-04-02
The parties
- Patient
- patient Elinore Danyelle Streich
- Provider
- provider Tyrone Stracke
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
03b3068a-a726-461a-554a-25d0007c44b6