General examination of patient

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patient Osvaldo Sebastian Medhurst
General examination of patient

Claim total

$641.13

base $93.83 · payer covered $491.13

The visit

Class: Wellness
Code: 162673000
Reason: —
Start: 1966-10-13
Stop: 1966-10-13

The parties

Patient: patient Osvaldo Sebastian Medhurst
Provider: provider Ursula Nolan
Care site: care site INDIAN HEALTH BOARD OF MINNEAPOLIS INC
Payer: payer Medicaid

Record id 0366d403-b006-0b76-04ab-31236da6bd77