Claim total
$917.37
base $93.83 · payer covered $767.37
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2000-02-21
- Stop
- 2000-02-21
The parties
- Patient
- patient Geralyn Berniece Kirlin
- Provider
- provider Shonta Hayes
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
18ec76c4-019a-43be-f234-11495e64a0e5