Claim total
$1,018.11
base $93.83 · payer covered $868.11
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2003-10-23
- Stop
- 2003-10-23
The parties
- Patient
- patient Eula Hane
- Provider
- provider Sofia Conroy
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
1c92c362-fad3-18d7-0db0-28357be8fe64