Claim total
$899.40
base $93.83 · payer covered $749.40
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1995-12-11
- Stop
- 1995-12-11
The parties
- Patient
- patient Shon Stewart Considine
- Provider
- provider Shoshana Runolfsdottir
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
2e06e0f7-a404-4867-12ac-e00731d08ad2