Claim total
$773.83
base $93.83 · payer covered $673.83
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2013-07-01
- Stop
- 2013-07-01
The parties
- Patient
- patient Alyssa Star Feil
- Provider
- provider Alesha Wilderman
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
02cca109-7737-4ad8-59a2-9c9f9012c668