Claim total
$1,171.35
base $93.83 · payer covered $1,021.35
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1953-03-20
- Stop
- 1953-03-20
The parties
- Patient
- patient Arthur Pablo Greenfelder
- Provider
- provider Danilo Haley
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
028512d5-49bb-87e7-0391-92c4c5093e36