Claim total
$972.12
base $93.83 · payer covered $972.12
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-07-20
- Stop
- 2016-07-20
The parties
- Patient
- patient Natacha Mertz
- Provider
- provider Samantha Schmidt
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Dual Eligible
Record id
26aae4f1-7e29-a4a4-1b9d-ada5357f5396