Claim total
$1,041.77
base $93.83 · payer covered $891.77
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1985-03-31
- Stop
- 1985-03-31
The parties
- Patient
- patient Nicolas Don Collins
- Provider
- provider Jeanie Senger
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
2e132137-5ff4-645c-fd81-744a0c86aeb7