Claim total
$908.63
base $93.83 · payer covered $808.63
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2024-11-15
- Stop
- 2024-11-15
The parties
- Patient
- patient Carmel Candace Corwin
- Provider
- provider Joaquin Krajcik
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
05f2be84-5448-13b2-305f-a5792b04272b