Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-05-03
- Stop
- 2019-05-03
The parties
- Patient
- patient Carolynn Gabriele Zemlak
- Provider
- provider Joaquin Krajcik
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
032e4024-8595-f612-89b7-90aa1ae93475