Claim total
$913.13
base $93.83 · payer covered $813.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-07-08
- Stop
- 2016-07-08
The parties
- Patient
- patient Mallory Bobette Stehr
- Provider
- provider Landon Beer
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
0ebd7f5a-eab8-697e-0368-79d9fafd2ead