Claim total
$498.76
base $93.83 · payer covered $398.76
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2021-07-15
- Stop
- 2021-07-15
The parties
- Provider
- provider Bradley Terry
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
04dc5210-87cc-ee45-2f9d-9fbd019c1a1a