Claim total
$979.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2007-10-04
- Stop
- 2007-10-04
The parties
- Patient
- patient Celena Kim Champlin
- Provider
- provider Danilo Haley
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Cigna Health
Record id
076b2127-cf52-7b65-6cf6-1790e2e8cc2d