Claim total
$775.00
base $93.83 · payer covered $433.59
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2026-07-18
- Stop
- 2026-07-18
The parties
- Patient
- patient Santo Quentin Mueller
- Provider
- provider Winfred Gaylord
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicare
Record id
01845754-7d83-d7eb-1134-5067f35a39ad