Claim total
$775.00
base $93.83 · payer covered $625.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1996-01-04
- Stop
- 1996-01-04
The parties
- Patient
- patient Katie Glynis Lang
- Provider
- provider Ignacio Paredes
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
3651568f-224f-59a6-8960-e46ff43daa5a