Claim total
$1,229.95
base $93.83 · payer covered $983.95
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-03-16
- Stop
- 2014-03-16
The parties
- Patient
- patient Bryant Lindsey Kris
- Provider
- provider Dirk D'Amore
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicare
Record id
01c56dba-0d82-4ea3-6d3c-7e9ca823e26a