Claim total
$641.13
base $93.83 · payer covered $541.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-02-06
- Stop
- 2024-02-06
The parties
- Patient
- patient Elinore Danyelle Streich
- Provider
- provider Ignacio Paredes
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
03b3068a-a726-461a-afcc-b6c52861354d