Claim total
$1,115.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2000-03-30
- Stop
- 2000-03-30
The parties
- Patient
- patient Theresia Kylie Ferry
- Provider
- provider Norris Kertzmann
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
20b286d8-4a17-89cc-bee0-388b9f4f3c8f