Claim total
$1,463.73
base $93.83 · payer covered $4.58
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-01-26
- Stop
- 2017-01-26
The parties
- Patient
- patient Alison Ashlea Frami
- Provider
- provider Danilo Haley
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Anthem
Record id
023818a4-3852-fbab-fe29-34594e1cbcea