Claim total
$843.43
base $93.83 · payer covered $843.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2009-08-09
- Stop
- 2009-08-09
The parties
- Patient
- patient Adella Portia Wolf
- Provider
- provider Linwood Schimmel
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
1aecd3e0-487a-0af8-5d8e-bc5714e79e4b