Claim total
$767.69
base $93.83 · payer covered $427.75
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-09-24
- Stop
- 2018-09-24
The parties
- Patient
- patient Colton Eloy Yost
- Provider
- provider Nicolas Raynor
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicare
Record id
00f38984-ead0-d444-b114-940d02700251