Claim total
$777.13
base $93.83 · payer covered $777.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-04-06
- Stop
- 2025-04-06
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-b9f9-277e085b5dd4