Claim total
$1,402.92
base $93.83 · payer covered $1,302.92
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-08-23
- Stop
- 2023-08-23
The parties
- Patient
- patient Ivonne Senger
- Provider
- provider Norris Kertzmann
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
227fef4b-368a-4c5e-8f8c-5fe6a979dd95