Claim total
$1,540.28
base $93.83 · payer covered $140.54
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2025-08-13
- Stop
- 2025-08-13
The parties
- Patient
- patient Anderson Randell Stracke
- Provider
- provider Hiram Nitzsche
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Anthem
Record id
0205f653-6551-192d-997f-6e6c7e220c62