Claim total
$772.84
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1979-05-19
- Stop
- 1979-05-19
The parties
- Patient
- patient Santo Quentin Mueller
- Provider
- provider Winfred Gaylord
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
01845754-7d83-d7eb-0d2c-2c55919a08e2