Claim total
$972.12
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2011-09-23
- Stop
- 2011-09-23
The parties
- Patient
- patient Rea Wilderman
- Provider
- provider Norris Kertzmann
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Aetna
Record id
06d9b168-6ea1-82f4-fa2f-9bf5bb321aef