Claim total
$1,210.06
base $93.83 · payer covered $1,103.45
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1995-07-15
- Stop
- 1995-07-15
The parties
- Patient
- patient Alvin Tracy Morar
- Provider
- provider Trevor Williamson
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
00df058f-9df4-4d69-fb27-8983cb665d76