Claim total
$1,112.41
base $93.83 · payer covered $1,012.41
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2024-01-10
- Stop
- 2024-01-10
The parties
- Patient
- patient Ronald Inga Torphy
- Provider
- provider Maryam Wolf
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
05af61d0-e78c-a60a-6b70-de2f9583c053