Claim total
$1,321.08
base $93.83 · payer covered $1,171.08
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1997-10-25
- Stop
- 1997-10-25
The parties
- Patient
- patient Charlott Yi Walter
- Provider
- provider Vicente McClure
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
1508a0e5-67d3-1dfd-9371-3a5f70204d50