Claim total
$641.13
base $93.83 · payer covered $541.13
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2022-11-04
- Stop
- 2022-11-04
The parties
- Patient
- patient Carmel Candace Corwin
- Provider
- provider Kanesha Bruen
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
05f2be84-5448-13b2-05e2-62c20180b543