Claim total
$906.76
base $93.83 · payer covered $806.76
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2024-02-22
- Stop
- 2024-02-22
The parties
- Patient
- patient Daron Cormier
- Provider
- provider Shoshana Runolfsdottir
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
061edbc8-fb70-a6fd-74f7-3e7588215753