Claim total
$767.69
base $93.83 · payer covered $430.08
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-04-17
- Stop
- 2018-04-17
The parties
- Patient
- patient Rocio Margarita Alcaraz
- Provider
- provider Hermine Stoltenberg
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicare
Record id
0274bb53-c777-eb96-9376-a56c3c11dd18