Claim total
$979.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-07-24
- Stop
- 2024-07-24
The parties
- Patient
- patient Eartha Mollie Lang
- Provider
- provider Vena Champlin
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Humana
Record id
35432f52-0690-837a-be77-1b5c0e1cf262