Claim total
$1,049.08
base $93.83 · payer covered $1,049.08
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2008-04-01
- Stop
- 2008-04-01
The parties
- Patient
- patient Lincoln Moses Mueller
- Provider
- provider Roberto Schaden
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
1d55f8ae-f39b-a58c-c169-ca8c79524e83