Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2017-08-11
- Stop
- 2017-08-11
The parties
- Patient
- patient Florinda Suzanna Lehner
- Provider
- provider Vena Champlin
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
05d39322-006c-95d6-b138-66b4d5e08c95