Claim total
$1,112.41
base $93.83 · payer covered $1,112.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-11-19
- Stop
- 2024-11-19
The parties
- Patient
- patient Mirta Nakisha Franecki
- Provider
- provider Landon Beer
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
05902870-85f1-fda1-86ed-d4c6b64a6ecd