Claim total
$711.72
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1985-09-29
- Stop
- 1985-09-29
The parties
- Patient
- patient Bryant Lindsey Kris
- Provider
- provider Dirk D'Amore
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
01c56dba-0d82-4ea3-f5ce-978c9fd65286