Claim total
$1,193.40
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-05-26
- Stop
- 2024-05-26
The parties
- Patient
- patient Seymour Corwin
- Provider
- provider Vena Champlin
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Humana
Record id
106f5504-e2b7-19e0-9ef8-cc24daa2791b