Claim total
$910.06
base $93.83 · payer covered $810.06
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2020-02-03
- Stop
- 2020-02-03
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-b782-368dda2cfa39