Claim total
$976.41
base $93.83 · payer covered $826.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2000-04-25
- Stop
- 2000-04-25
The parties
- Patient
- patient Louella Roberts
- Provider
- provider Tim Borer
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
05092f50-4c35-2d72-989a-bcc593f2446f