Claim total
$1,457.08
base $93.83 · payer covered $1,457.08
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2010-02-22
- Stop
- 2010-02-22
The parties
- Patient
- patient Sarina Alisa Sanford
- Provider
- provider Dexter Yundt
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
258adedd-a3fb-a6a3-28c2-53b6fc4bf613