Claim total
$1,186.30
base $93.83 · payer covered $763.73
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2026-05-03
- Stop
- 2026-05-03
The parties
- Patient
- patient Isaac Vernon Marvin
- Provider
- provider Hiram Nitzsche
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicare
Record id
007e08f5-37d5-91e8-077d-d575174e11ef