Claim total
$871.77
base $93.83 · payer covered $871.77
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-01-14
- Stop
- 2024-01-14
The parties
- Patient
- patient Crista Karina Nienow
- Provider
- provider Niki O'Kon
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Aetna
Record id
0266f4cc-2c2d-37bb-5137-82a763ebf1af