Claim total
$711.72
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-06-25
- Stop
- 2025-06-25
The parties
- Patient
- patient Jefferson Fredrick Stamm
- Provider
- provider Vena Champlin
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Humana
Record id
02e8a145-6422-3c9c-910e-259c587d2335