Claim total
$1,396.17
base $93.83 · payer covered $1,396.17
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2018-02-25
- Stop
- 2018-02-25
The parties
- Patient
- patient Cecil Norberto Franecki
- Provider
- provider Vicente McClure
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
05e47734-a2d3-8a46-074f-2f43ab417853