Claim total
$773.83
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2014-12-09
- Stop
- 2014-12-09
The parties
- Patient
- patient Iona Emmerich
- Provider
- provider Vena Champlin
- Care site
- care site HENNEPIN COUNTY
Record id
03622442-8577-b4cb-585b-2756bf87a9c9