Claim total
$1,088.55
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1984-04-27
- Stop
- 1984-04-27
The parties
- Patient
- patient Joaquín Rubén Aguilera
- Provider
- provider Vena Champlin
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
34f138ed-2da1-2355-2e4e-22b5427e25a9