Claim total
$229.83
base $93.83 · payer covered $229.83
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2013-04-26
- Stop
- 2013-04-26
The parties
- Patient
- patient Ramona Schinner
- Provider
- provider Vena Champlin
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
032000cf-30b4-7e9b-b8af-28a5c3cec3f0