Claim total
$1,047.00
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-01-16
- Stop
- 2019-01-16
The parties
- Patient
- patient Roxie Leannon
- Provider
- provider Vena Champlin
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
3ada161d-facd-4476-28d1-4012066a0475