Claim total
$773.83
base $93.83 · payer covered $773.83
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2021-12-23
- Stop
- 2021-12-23
The parties
- Provider
- provider Toby Abshire
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
04dc5210-87cc-ee45-4e99-774389730359