Claim total
$1,112.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2015-11-16
- Stop
- 2015-11-16
The parties
- Patient
- patient Minnie Cassin
- Provider
- provider Vena Champlin
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Anthem
Record id
01e5652d-7e46-45b8-7b3a-fac5c3b4a146