Claim total
$1,049.08
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1985-02-08
- Stop
- 1985-02-08
The parties
- Patient
- patient Roy Alfonzo Huel
- Provider
- provider Hiram Nitzsche
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
0b35d6cf-7bf9-dc99-0ccc-d27f8d468b74