Claim total
$4,589.46
base $93.83 · payer covered $4,554.46
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1976-02-27
- Stop
- 1976-02-27
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-87e7-994a-dc69ae1126d0