Claim total
$899.40
base $93.83 · payer covered $749.40
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1995-04-24
- Stop
- 1995-04-24
The parties
- Patient
- patient Lawrence Daugherty
- Provider
- provider Kanesha Bruen
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
09df0285-fddb-28fc-e2ac-306221793974