Claim total
$772.84
base $93.83 · payer covered $622.84
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1991-10-23
- Stop
- 1991-10-23
The parties
- Patient
- patient Ivonne Senger
- Provider
- provider Vena Champlin
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
227fef4b-368a-4c5e-163a-09c736960013