Claim total
$641.13
base $93.83 · payer covered $641.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-12-04
- Stop
- 2019-12-04
The parties
- Patient
- patient Deirdre Shannon Hayes
- Provider
- provider Jeanie Senger
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
0194ec83-bb8c-3a71-6f05-17b2ac33aa7b