Claim total
$1,109.39
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1989-11-15
- Stop
- 1989-11-15
The parties
- Patient
- patient Boyce Jerrold Johns
- Provider
- provider Hiram Nitzsche
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
18cbb615-420a-8641-ab25-2cc65ee35d9a