Claim total
$846.78
base $93.83 · payer covered $696.78
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2001-01-08
- Stop
- 2001-01-08
The parties
- Patient
- patient Elliot Blaine Buckridge
- Provider
- provider Norris Kertzmann
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
00a5a31e-a2f8-175f-3f25-e9f210b2b28b