Claim total
$1,244.12
base $93.83 · payer covered $1,144.12
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2020-07-22
- Stop
- 2020-07-22
The parties
- Patient
- patient Grace Marybelle Kuvalis
- Provider
- provider Dexter Yundt
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
35646793-8e5d-1241-4d3f-37ab867b05fa