Claim total
$641.13
base $93.83 · payer covered $591.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2001-03-20
- Stop
- 2001-03-20
The parties
- Patient
- patient Elinore Danyelle Streich
- Provider
- provider Tyrone Stracke
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
03b3068a-a726-461a-329c-4289aa76c529