Claim total
$1,007.07
base $93.83 · payer covered $1,007.07
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2023-12-08
- Stop
- 2023-12-08
The parties
- Patient
- patient Ramona Schinner
- Provider
- provider Vena Champlin
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Dual Eligible
Record id
032000cf-30b4-7e9b-b1e7-58ee1e413ec7