Claim total
$1,185.35
base $93.83 · payer covered $1,085.35
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2020-01-28
- Stop
- 2020-01-28
The parties
- Patient
- patient Elinore Danyelle Streich
- Provider
- provider Maryam Wolf
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
03b3068a-a726-461a-1e20-59f7de185d5b