Claim total
$985.80
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2002-03-13
- Stop
- 2002-03-13
The parties
- Patient
- patient Roxie Leannon
- Provider
- provider Norris Kertzmann
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
3ada161d-facd-4476-2145-4c353c73410b