Claim total
$1,115.71
base $93.83 · payer covered $1,115.71
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2019-01-24
- Stop
- 2019-01-24
The parties
- Patient
- patient Daron Cormier
- Provider
- provider Tim Borer
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
061edbc8-fb70-a6fd-041e-5dbc22294ad9