Claim total
$1,112.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-10-01
- Stop
- 2016-10-01
The parties
- Patient
- patient Arlen Schamberger
- Provider
- provider Samantha Schmidt
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
01ee9e96-5701-e5d2-44fe-8191101a771d