Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2003-07-23
- Stop
- 2003-07-23
The parties
- Patient
- patient Saul Little
- Provider
- provider Hiram Nitzsche
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
0205c336-938f-d85a-0c09-4ce86589b080