Claim total
$1,041.77
base $93.83 · payer covered $891.77
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1957-08-30
- Stop
- 1957-08-30
The parties
- Patient
- patient Sharell Herma Schaden
- Provider
- provider Jeanie Senger
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
19f98f29-fa6f-31a8-6c2e-312b6cde3b3a