Claim total
$1,185.08
base $93.83 · payer covered $1,035.08
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2005-04-17
- Stop
- 2005-04-17
The parties
- Patient
- patient Randell Irvin Gutmann
- Provider
- provider Vernon Labadie
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
08da25e3-3ae1-e835-5a59-34616d02f870