Claim total
$846.78
base $93.83 · payer covered $746.78
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2006-05-17
- Stop
- 2006-05-17
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-b025-54ea0fe2569a