Claim total
$229.83
base $93.83 · payer covered $129.83
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2016-09-30
- Stop
- 2016-09-30
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-e731-5e04df5a72e1