Claim total
$1,046.06
base $93.83 · payer covered $1,046.06
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2008-06-25
- Stop
- 2008-06-25
The parties
- Provider
- provider Morgan Crona
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
010d736c-d81f-3cd7-ee91-15327d177809