Claim total
$1,049.08
base $93.83 · payer covered $899.08
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1991-04-09
- Stop
- 1991-04-09
The parties
- Patient
- patient Earle Delmer O'Keefe
- Provider
- provider Norris Kertzmann
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
0fab17d0-04f6-462b-ad50-373e256f0af3