Claim total
$711.72
base $93.83 · payer covered $561.72
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1970-01-23
- Stop
- 1970-01-23
The parties
- Patient
- patient Arthur Pablo Greenfelder
- Provider
- provider Alesha Wilderman
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
028512d5-49bb-87e7-1c8b-dd858610d094