Claim total
$1,251.71
base $93.83 · payer covered $818.08
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2009-04-27
- Stop
- 2009-04-27
The parties
- Patient
- patient Genaro Tomas Kertzmann
- Provider
- provider Hope Wisoky
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicare
Record id
17191b9b-02e3-d772-019c-3575233cbbcb