Claim total
$982.78
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2016-11-21
- Stop
- 2016-11-21
The parties
- Patient
- patient Minnie Cassin
- Provider
- provider Vena Champlin
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Anthem
Record id
01e5652d-7e46-45b8-786e-d2e6560334ab