Claim total
$916.15
base $93.83 · payer covered $916.15
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2008-08-14
- Stop
- 2008-08-14
The parties
- Patient
- patient Maurice Palmer Stamm
- Provider
- provider Vena Champlin
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
2924da49-d719-85a1-c5c3-c9e3e08ccd31