Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-01-21
- Stop
- 2016-01-21
The parties
- Patient
- patient Alison Ashlea Frami
- Provider
- provider Alesha Wilderman
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Aetna
Record id
023818a4-3852-fbab-b2c1-3a3f9f828173