Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1978-12-22
- Stop
- 1978-12-22
The parties
- Patient
- patient Oscar Ricky Gerlach
- Provider
- provider Hiram Nitzsche
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
2dbeb246-a994-b355-4e70-6152934d3088