Claim total
$843.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-03-27
- Stop
- 2015-03-27
The parties
- Patient
- patient Duncan Sanford Ratke
- Provider
- provider Norris Kertzmann
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
243a5936-ea31-a01d-3d7b-3fcb4fc4c165