Claim total
$1,461.09
base $93.83 · payer covered $1,311.09
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1999-10-09
- Stop
- 1999-10-09
The parties
- Patient
- patient Elbert Rod Lemke
- Provider
- provider Maryam Wolf
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
039e51d1-c563-811d-55be-890c22afc414