Claim total
$13,831.38
base $93.83 · payer covered $9,898.70
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2012-10-18
- Stop
- 2012-10-19
The parties
- Patient
- patient Jerrell Alphonso Goodwin
- Provider
- provider Norris Kertzmann
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer UnitedHealthcare
Record id
1e1c547c-f108-6b5c-85de-6e63ded30c30