Claim total
$641.13
base $93.83 · payer covered $541.13
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2017-07-24
- Stop
- 2017-07-24
The parties
- Patient
- patient Alyssa Star Feil
- Provider
- provider Danilo Haley
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
02cca109-7737-4ad8-6ec5-88c214491b9a