Claim total
$964.08
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-01-19
- Stop
- 2025-01-19
The parties
- Patient
- patient Crista Karina Nienow
- Provider
- provider Joaquin Krajcik
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Cigna Health
Record id
0266f4cc-2c2d-37bb-1480-a36ff502bf24