Claim total
$846.78
base $93.83 · payer covered $746.78
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2023-12-21
- Stop
- 2023-12-21
The parties
- Provider
- provider Margarite Dibbert
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Medicaid
Record id
04dc5210-87cc-ee45-bdd8-4622075c737e