Claim total
$392.58
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2017-09-05
- Stop
- 2017-09-05
The parties
- Patient
- patient Iona Emmerich
- Provider
- provider Vena Champlin
- Care site
- care site HENNEPIN COUNTY
Record id
03622442-8577-b4cb-c13d-e8193c9727c9