Claim total
$767.69
base $93.83 · payer covered $614.14
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-05-18
- Stop
- 2025-05-18
The parties
- Patient
- patient Bryant Lindsey Kris
- Provider
- provider Efren Sporer
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicare
Record id
01c56dba-0d82-4ea3-9c88-f6c5bb2510d1