Claim total
$846.78
base $93.83 · payer covered $846.78
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-03-13
- Stop
- 2019-03-13
The parties
- Provider
- provider Jarred Jenkins
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
05836489-c27c-5168-83d0-5c47702a876e