Claim total
$840.41
base $93.83 · payer covered $740.41
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2023-11-10
- Stop
- 2023-11-10
The parties
- Patient
- patient Carmel Candace Corwin
- Provider
- provider Niki O'Kon
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
05f2be84-5448-13b2-b44f-dc9ad3fc5156