Claim total
$1,226.80
base $93.83 · payer covered $1,076.80
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1994-03-14
- Stop
- 1994-03-14
The parties
- Provider
- provider Landon Beer
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
04481159-34f8-6925-b665-4d5591c3a6cc