Claim total
$1,310.04
base $93.83 · payer covered $1,160.04
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1998-09-24
- Stop
- 1998-09-24
The parties
- Patient
- patient Eula Hane
- Provider
- provider Sofia Conroy
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
1c92c362-fad3-18d7-4cb3-336d4d58fa66