Claim total
$641.13
base $93.83 · payer covered $641.13
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2017-02-19
- Stop
- 2017-02-19
The parties
- Patient
- patient Cecil Norberto Franecki
- Provider
- provider Vicente McClure
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
05e47734-a2d3-8a46-06ee-7a2c61f6e67c