Claim total
$1,011.53
base $93.83 · payer covered $861.53
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2002-03-06
- Stop
- 2002-03-06
The parties
- Provider
- provider Miki Kirlin
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
05836489-c27c-5168-3fc7-a22a2a409652