Claim total
$641.13
base $93.83 · payer covered $591.13
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1963-06-01
- Stop
- 1963-06-01
The parties
- Patient
- patient Danilo Volkman
- Provider
- provider Vena Champlin
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
36724fda-fdcf-8680-619a-9068e0be2b5c