Claim total
$838.28
base $93.83 · payer covered $489.21
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-03-29
- Stop
- 2015-03-29
The parties
- Patient
- patient Santiago Víctor Cavazos
- Provider
- provider Vena Champlin
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicare
Record id
157c2e9c-d23e-1a11-c347-b9cfa53a8ae5