Claim total
$1,302.67
base $93.83 · payer covered $1,042.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-07-12
- Stop
- 2025-07-12
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-6dbd-0d7fc75b1de7