Claim total
$1,463.73
base $93.83 · payer covered $1,463.73
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-02-24
- Stop
- 2016-02-24
The parties
- Provider
- provider Jarred Jenkins
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
05836489-c27c-5168-fd3f-936cc795191a