Claim total
$1,408.58
base $93.83 · payer covered $1,351.97
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-01-27
- Stop
- 2014-01-27
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-9e32-678b8dcca4e8