Claim total
$1,729.31
base $93.83 · payer covered $1,579.31
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1999-08-01
- Stop
- 1999-08-01
The parties
- Patient
- patient Sha Kohler
- Provider
- provider Roberto Schaden
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
19dce853-ad87-d82e-cb52-26dd730984ce