Claim total
$1,356.79
base $93.83 · payer covered $1,256.79
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2026-09-14
- Stop
- 2026-09-14
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-bbb6-b3c8452cf876