Claim total
$979.43
base $93.83 · payer covered $829.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2001-05-15
- Stop
- 2001-05-15
The parties
- Patient
- patient Latoyia Runolfsdottir
- Provider
- provider Sofia Conroy
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
251b2d21-b2f3-af19-4b95-335073c2fdde