Claim total
$1,151.94
base $93.83 · payer covered $1,051.94
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2023-08-28
- Stop
- 2023-08-28
The parties
- Patient
- patient Alyssa Star Feil
- Provider
- provider Danilo Haley
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
02cca109-7737-4ad8-9679-0df0c4bac659