Claim total
$780.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1987-04-20
- Stop
- 1987-04-20
The parties
- Patient
- patient Julio Hayden Haag
- Provider
- provider Norris Kertzmann
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
36f895c5-cf8f-4086-b55f-e4aa6d3e3981