Claim total
$966.18
base $93.83 · payer covered $816.18
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1994-03-08
- Stop
- 1994-03-08
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-d716-ed99c824d604