Claim total
$505.13
base $93.83 · payer covered $505.13
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2020-12-23
- Stop
- 2020-12-23
The parties
- Patient
- patient Ronald Inga Torphy
- Provider
- provider Will Leuschke
- Care site
- care site HENNEPIN HEALTHCARE SYSTEM INC
- Payer
- payer Medicaid
Record id
05af61d0-e78c-a60a-ce56-c8941e24b4d5