Claim total
$4,176.98
base $93.83 · payer covered $2,399.53
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-11-01
- Stop
- 2019-11-01
The parties
- Patient
- patient Rea Wilderman
- Provider
- provider Norris Kertzmann
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Anthem
Record id
06d9b168-6ea1-82f4-1e7a-2811945ee3ce