Claim total
$1,243.12
base $93.83 · payer covered $1,243.12
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2026-06-25
- Stop
- 2026-06-25
The parties
- Provider
- provider Bradley Terry
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
04dc5210-87cc-ee45-78f8-2a4bffb29918