Claim total
$13,901.94
base $93.83 · payer covered $13,751.94
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1975-02-21
- Stop
- 1975-02-21
The parties
- Patient
- patient Arthur Pablo Greenfelder
- Provider
- provider Dexter Yundt
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
028512d5-49bb-87e7-c8b0-02a540bc7648