Claim total
$1,049.08
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1963-09-18
- Stop
- 1963-09-18
The parties
- Patient
- patient Hans Marion Kuvalis
- Provider
- provider Joaquin Krajcik
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
107d0674-dc76-cfa0-f579-918c19999327