Claim total
$840.41
base $93.83 · payer covered $690.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1997-02-03
- Stop
- 1997-02-03
The parties
- Patient
- patient Fawn Fred Considine
- Provider
- provider Vicente McClure
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
3ac9b22c-79ba-7b95-8826-f7656270c95e