Claim total
$1,257.80
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2013-08-01
- Stop
- 2013-08-01
The parties
- Patient
- patient Bettye Jeannetta Stamm
- Provider
- provider Hiram Nitzsche
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer UnitedHealthcare
Record id
35bc384f-9e87-79c6-2be7-1a2c36a385ee