Claim total
$838.28
base $93.83 · payer covered $738.28
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2009-02-17
- Stop
- 2009-02-17
The parties
- Patient
- patient Earle Delmer O'Keefe
- Provider
- provider Norris Kertzmann
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
0fab17d0-04f6-462b-880a-03a293287aee