Claim total
$1,039.69
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2013-09-27
- Stop
- 2013-09-27
The parties
- Patient
- patient Rea Wilderman
- Provider
- provider Vena Champlin
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Anthem
Record id
06d9b168-6ea1-82f4-5c19-c04a6ffeaaf6