Claim total
$1,222.20
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1983-09-18
- Stop
- 1983-09-18
The parties
- Patient
- patient Bryant Lindsey Kris
- Provider
- provider Efren Sporer
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
01c56dba-0d82-4ea3-6ee1-7dcf0a5704a4