Claim total
$641.13
base $93.83 · payer covered $491.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1998-06-11
- Stop
- 1998-06-11
The parties
- Patient
- patient Johnny Mattie Skiles
- Provider
- provider Vina Durgan
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
01f72a06-0d81-377c-1cfd-7c7486b69f0d