Claim total
$1,306.34
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1983-05-05
- Stop
- 1983-05-05
The parties
- Patient
- patient Karie Schultz
- Provider
- provider Vena Champlin
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
2ea550a0-4b81-96d6-0e68-c535e01c4c4f