Claim total
$11,774.41
base $93.83 · payer covered $11,774.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2020-09-08
- Stop
- 2020-09-08
The parties
- Patient
- patient Lillian Billye O'Conner
- Provider
- provider Winfred Gaylord
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
3248f34a-b42c-3b54-0383-31459efaadad