Claim total
$435.48
base $93.83 · payer covered $328.87
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1989-05-09
- Stop
- 1989-05-09
The parties
- Patient
- patient Lillian Billye O'Conner
- Provider
- provider Vicente McClure
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
3248f34a-b42c-3b54-3b56-31bf9cd339af