Claim total
$641.13
base $93.83 · payer covered $491.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1991-08-10
- Stop
- 1991-08-10
The parties
- Patient
- patient Leslee Christiansen
- Provider
- provider Brynn Jones
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
01280686-ae2e-42f0-6c0e-d6b7a32af424