Claim total
$1,182.06
base $93.83 · payer covered $1,082.06
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-11-12
- Stop
- 2014-11-12
The parties
- Patient
- patient Deirdre Shannon Hayes
- Provider
- provider Jeanie Senger
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
0194ec83-bb8c-3a71-16a4-34abcf9d2d8a