Claim total
$973.34
base $93.83 · payer covered $873.34
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2022-02-01
- Stop
- 2022-02-01
The parties
- Patient
- patient Elinore Danyelle Streich
- Provider
- provider Will Leuschke
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
03b3068a-a726-461a-65d8-57c8447461d2