Claim total
$1,186.06
base $93.83 · payer covered $1,036.06
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1977-03-16
- Stop
- 1977-03-16
The parties
- Patient
- patient Bill Antonio Gleason
- Provider
- provider Vina Durgan
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
29eef510-cf92-084f-e5cd-4bca94a05778