Claim total
$1,343.78
base $93.83 · payer covered $475.61
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-05-14
- Stop
- 2016-05-14
The parties
- Patient
- patient Heriberto Orval Feest
- Provider
- provider Efren Sporer
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer UnitedHealthcare
Record id
04dd6dd9-2faa-05da-d098-8a53bb632dfc