Claim total
$862.79
base $93.83 · payer covered $762.79
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2018-10-16
- Stop
- 2018-10-16
The parties
- Patient
- patient Mirta Nakisha Franecki
- Provider
- provider Landon Beer
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
05902870-85f1-fda1-3ed5-10a814069b85