Claim total
$910.06
base $93.83 · payer covered $910.06
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-02-12
- Stop
- 2014-02-12
The parties
- Provider
- provider Jarred Jenkins
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
05836489-c27c-5168-3374-92726ea71c9d