Claim total
$976.41
base $93.83 · payer covered $876.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2022-05-05
- Stop
- 2022-05-05
The parties
- Patient
- patient Johnny Mattie Skiles
- Provider
- provider Jamison Rau
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
01f72a06-0d81-377c-ce6e-eb6a878c12c5