Claim total
$93.83
base $93.83 · payer covered $93.83
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2014-01-16
- Stop
- 2014-01-16
The parties
- Patient
- patient Daron Cormier
- Provider
- provider Tim Borer
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
061edbc8-fb70-a6fd-a020-26ed387923ba