Claim total
$917.37
base $93.83 · payer covered $767.37
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1967-01-06
- Stop
- 1967-01-06
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-ccc6-9da8dafb8705