Claim total
$1,177.07
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-10-05
- Stop
- 2019-10-05
The parties
- Patient
- patient Arlen Schamberger
- Provider
- provider Samantha Schmidt
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
01ee9e96-5701-e5d2-53d9-33a29047b3b1