Claim total
$846.78
base $93.83 · payer covered $746.78
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2019-08-23
- Stop
- 2019-08-23
The parties
- Patient
- patient Florinda Suzanna Lehner
- Provider
- provider Vena Champlin
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
05d39322-006c-95d6-ed6b-0c8a13b00ec6