Claim total
$780.15
base $93.83 · payer covered $707.42
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1981-05-14
- Stop
- 1981-05-14
The parties
- Patient
- patient Benedict Alvin Armstrong
- Provider
- provider Efren Sporer
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
2c61caa8-0470-e3a1-eef0-9c15aa3247d0