Claim total
$917.37
base $93.83 · payer covered $767.37
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1971-01-29
- Stop
- 1971-01-29
The parties
- Patient
- patient Arthur Pablo Greenfelder
- Provider
- provider Danilo Haley
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
028512d5-49bb-87e7-2fe7-a744b6a5cd18