Claim total
$906.71
base $93.83 · payer covered $906.71
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-12-24
- Stop
- 2018-12-24
The parties
- Patient
- patient Kareen Pfeffer
- Provider
- provider Vicente McClure
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
14e28a38-73f9-f96b-9762-8b554058161b