Claim total
$777.13
base $93.83 · payer covered $742.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1990-06-06
- Stop
- 1990-06-06
The parties
- Patient
- patient Susanna Avis Emard
- Provider
- provider Dexter Yundt
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Dual Eligible
Record id
0443166c-c803-503e-795f-a27fbeb7d822