Claim total
$772.84
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2005-02-24
- Stop
- 2005-02-24
The parties
- Patient
- patient Rocio Norma Muñoz
- Provider
- provider Vena Champlin
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
0c6b4c76-1df9-a658-a1cc-13ff54a84387