Claim total
$13,497.04
base $93.83 · payer covered $13,462.04
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1979-03-16
- Stop
- 1979-03-16
The parties
- Patient
- patient Arthur Pablo Greenfelder
- Provider
- provider Danilo Haley
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Dual Eligible
Record id
028512d5-49bb-87e7-2b74-c5a9b94caaf8