Claim total
$1,175.81
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2022-08-23
- Stop
- 2022-08-23
The parties
- Patient
- patient Zulema Eloisa Kunde
- Provider
- provider Efren Sporer
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Aetna
Record id
2e0c5db6-de77-c14a-36d5-b2e1453ea32b