Claim total
$1,062.57
base $93.83 · payer covered $912.57
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1972-05-06
- Stop
- 1972-05-06
The parties
- Patient
- patient Santo Quentin Mueller
- Provider
- provider Winfred Gaylord
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
01845754-7d83-d7eb-7f61-d26aa0a89591