Claim total
$775.00
base $93.83 · payer covered $619.99
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2022-10-20
- Stop
- 2022-10-20
The parties
- Patient
- patient Becki Yvonne Weimann
- Provider
- provider Vena Champlin
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer UnitedHealthcare
Record id
20189b2b-d97e-8e5e-407e-28364eb6eff8