Claim total
$641.13
base $93.83 · payer covered $541.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-02-11
- Stop
- 2017-02-11
The parties
- Patient
- patient Waltraud Tromp
- Provider
- provider Cheri Mitchell
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
1461ae1d-c357-fb97-f188-85b09806dddc