Claim total
$780.15
base $93.83 · payer covered $680.15
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2022-02-15
- Stop
- 2022-02-15
The parties
- Patient
- patient Justin Clemente Wiegand
- Provider
- provider Ignacio Paredes
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
1157d660-5b46-2e3c-b718-4e26e0a57d62