Claim total
$1,802.03
base $93.83 · payer covered $276.78
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2006-08-08
- Stop
- 2006-08-09
The parties
- Patient
- patient Blake Rudolph Von
- Provider
- provider Norris Kertzmann
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Anthem
Record id
01986319-54e6-598a-2247-2d68b2882300