Claim total
$1,251.43
base $93.83 · payer covered $1,151.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2009-09-13
- Stop
- 2009-09-13
The parties
- Patient
- patient Freddie Collins
- Provider
- provider Kanesha Bruen
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
2b6adf7d-df39-1086-a64a-2be1b381c382