Claim total
$775.00
base $93.83 · payer covered $625.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1991-07-18
- Stop
- 1991-07-18
The parties
- Patient
- patient Mikel Edmond Wisoky
- Provider
- provider Dexter Yundt
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
2973ea9a-f1cd-e339-70e6-1e0b5b8a1df0