Claim total
$772.84
base $93.83 · payer covered $622.84
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1983-04-18
- Stop
- 1983-04-18
The parties
- Patient
- patient August Darrel Dach
- Provider
- provider Dexter Yundt
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
092b8bdc-b84a-4582-e643-40de729a483a