Claim total
$1,185.08
base $93.83 · payer covered $1,135.08
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2005-07-18
- Stop
- 2005-07-18
The parties
- Provider
- provider Norris Kertzmann
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
312e3cf1-73f0-da20-92d1-8e1688a868a4