Claim total
$704.41
base $93.83 · payer covered $381.80
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-09-09
- Stop
- 2014-09-09
The parties
- Patient
- patient Stephanie Naomi Tremblay
- Provider
- provider Efren Sporer
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicare
Record id
3a8746e3-94a3-6688-28ef-d23e5ad47874