Claim total
$1,573.63
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2011-09-06
- Stop
- 2011-09-06
The parties
- Patient
- patient Abraham Mante
- Provider
- provider Norris Kertzmann
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Humana
Record id
1abdafbd-dcc9-f667-50dc-10bf13b52163