Claim total
$1,052.43
base $93.83 · payer covered $1,046.26
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2017-01-12
- Stop
- 2017-01-12
The parties
- Patient
- patient Daron Cormier
- Provider
- provider Tim Borer
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
061edbc8-fb70-a6fd-625f-8362bb0ac546