Claim total
$711.72
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-05-27
- Stop
- 2017-05-27
The parties
- Patient
- patient Santo Quentin Mueller
- Provider
- provider Winfred Gaylord
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer No insurance
Record id
01845754-7d83-d7eb-86ee-44a679deaa68