Claim total
$1,021.24
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-02-18
- Stop
- 2021-02-18
The parties
- Patient
- patient Alison Ashlea Frami
- Provider
- provider Alesha Wilderman
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Anthem
Record id
023818a4-3852-fbab-ad88-d2f191360e00