Claim total
$1,124.97
base $93.83 · payer covered $176.04
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-08-13
- Stop
- 2018-08-13
The parties
- Patient
- patient Scotty Thomas Ratke
- Provider
- provider Norris Kertzmann
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Anthem
Record id
2f3b1f3f-a4ca-67c8-ae9a-1d0a08b689c5