Claim total
$704.41
base $93.83 · payer covered $554.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1966-03-16
- Stop
- 1966-03-16
The parties
- Patient
- patient Susanna Avis Emard
- Provider
- provider Dexter Yundt
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
0443166c-c803-503e-cc8a-3658411fd951