Claim total
$767.69
base $93.83 · payer covered $667.69
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-11-15
- Stop
- 2017-11-15
The parties
- Patient
- patient Kera Fritsch
- Provider
- provider Jamison Rau
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
323fd4e3-b776-d805-fcdb-37c1190a541e