Claim total
$1,802.03
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1989-01-22
- Stop
- 1989-01-22
The parties
- Patient
- patient Fidel Russel
- Provider
- provider Joaquin Krajcik
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
2fefde94-f55b-b6a2-e06f-6f9cad5be019