Claim total
$967.34
base $93.83 · payer covered $773.86
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-04-25
- Stop
- 2021-04-25
The parties
- Patient
- patient Bryant Lindsey Kris
- Provider
- provider Dirk D'Amore
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicare
Record id
01c56dba-0d82-4ea3-200a-36a6af1470a2