Claim total
$1,338.51
base $93.83 · payer covered $1,238.51
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-11-21
- Stop
- 2025-11-21
The parties
- Patient
- patient Carmel Candace Corwin
- Provider
- provider Joaquin Krajcik
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
05f2be84-5448-13b2-8f53-77b43468da60