Claim total
$906.71
base $93.83 · payer covered $756.71
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1990-05-23
- Stop
- 1990-05-23
The parties
- Patient
- patient Marina Tina Yost
- Provider
- provider Dexter Yundt
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
1b0eb887-279e-786b-85bc-ff5f67feef92