Claim total
$701.11
base $93.83 · payer covered $601.11
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2018-10-12
- Stop
- 2018-10-12
The parties
- Patient
- patient Carmel Candace Corwin
- Provider
- provider Joaquin Krajcik
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
05f2be84-5448-13b2-f728-0d3a4f0da618