Claim total
$772.84
base $93.83 · payer covered $737.84
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1999-03-07
- Stop
- 1999-03-07
The parties
- Patient
- patient Santiago Víctor Cavazos
- Provider
- provider Norris Kertzmann
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Dual Eligible
Record id
157c2e9c-d23e-1a11-e05f-4be99cb33bae