Claim total
$772.84
base $93.83 · payer covered $772.84
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-04-07
- Stop
- 2023-04-07
The parties
- Patient
- patient Ashton Hisako Jaskolski
- Provider
- provider Jeanie Senger
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
2b9209bc-5607-5ae5-37e4-3a2d7e97fde8