Claim total
$291.66
base $155.66 · payer covered $141.66
The visit
- Class
- Outpatient
- Code
- 33879002
- Reason
- —
- Start
- 2025-01-08
- Stop
- 2025-01-08
The parties
- Patient
- patient Ronald Inga Torphy
- Provider
- provider Maryam Wolf
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
05af61d0-e78c-a60a-ecdc-65c9588258ab