Claim total
$1,191.57
base $93.83 · payer covered $953.24
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-04-02
- Stop
- 2017-04-02
The parties
- Patient
- patient Bryant Lindsey Kris
- Provider
- provider Thomasine Balistreri
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicare
Record id
01c56dba-0d82-4ea3-bd7f-1c4d4cfaa304