Claim total
$1,115.71
base $93.83 · payer covered $1,115.71
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2017-11-03
- Stop
- 2017-11-03
The parties
- Patient
- patient Ramona Schinner
- Provider
- provider Vena Champlin
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Dual Eligible
Record id
032000cf-30b4-7e9b-cb25-646dcc9ab352