Claim total
$1,112.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-09-06
- Stop
- 2024-09-06
The parties
- Patient
- patient Florinda Suzanna Lehner
- Provider
- provider Vena Champlin
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
05d39322-006c-95d6-313c-ad465b97a12e