Claim total
$982.78
base $93.83 · payer covered $882.78
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2016-10-04
- Stop
- 2016-10-04
The parties
- Patient
- patient Mirta Nakisha Franecki
- Provider
- provider Landon Beer
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
05902870-85f1-fda1-071a-a0d4f11d8512