Claim total
$780.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-05-14
- Stop
- 2015-05-14
The parties
- Patient
- patient Alvera Delsie Toy
- Provider
- provider Norris Kertzmann
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
1d1add62-9864-23be-b4a8-7ededa247730