Claim total
$1,460.39
base $93.83 · payer covered $1,310.39
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1972-02-04
- Stop
- 1972-02-04
The parties
- Patient
- patient Arthur Pablo Greenfelder
- Provider
- provider Alesha Wilderman
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
028512d5-49bb-87e7-4980-470cd88e3b38