Claim total
$1,029.41
base $93.83 · payer covered $979.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1986-04-06
- Stop
- 1986-04-06
The parties
- Patient
- patient Nicolas Don Collins
- Provider
- provider Jeanie Senger
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
2e132137-5ff4-645c-c61a-2e19003befca