Claim total
$505.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1938-12-13
- Stop
- 1938-12-13
The parties
- Patient
- patient Astrid Doria Dach
- Provider
- provider Danilo Haley
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Humana
Record id
02e7d6ac-dd81-002b-b27a-a91532f805ff