Claim total
$979.48
base $93.83 · payer covered $979.48
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2022-03-24
- Stop
- 2022-03-24
The parties
- Provider
- provider Margarite Dibbert
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
04dc5210-87cc-ee45-0730-0e611e2c506d