Claim total
$840.41
base $93.83 · payer covered $840.41
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2019-03-03
- Stop
- 2019-03-03
The parties
- Patient
- patient Cecil Norberto Franecki
- Provider
- provider Vicente McClure
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
05e47734-a2d3-8a46-1e18-c4d7e785612c