Claim total
$980.65
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1976-08-21
- Stop
- 1976-08-21
The parties
- Patient
- patient Arnold Otha Boyer
- Provider
- provider Vena Champlin
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
20cf8dcb-63b4-1f15-154b-fceda5daf393