Claim total
$777.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2017-12-10
- Stop
- 2017-12-10
The parties
- Patient
- patient Crista Karina Nienow
- Provider
- provider Joaquin Krajcik
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Aetna
Record id
0266f4cc-2c2d-37bb-ea07-d59a4eb2969a