Claim total
$5,990.20
base $93.83 · payer covered $5,940.20
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1986-04-23
- Stop
- 1986-04-23
The parties
- Patient
- patient Joey Norman Parker
- Provider
- provider Hiram Nitzsche
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
07e1cc91-ac43-613e-5da8-f9ad43c0c358