Claim total
$1,287.89
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-09-13
- Stop
- 2014-09-13
The parties
- Patient
- patient Marylou Abernathy
- Provider
- provider Norris Kertzmann
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Humana
Record id
364c439b-3ca4-d8e6-7054-a554635f6a45