Claim total
$780.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1972-09-30
- Stop
- 1972-09-30
The parties
- Patient
- patient Keith Blake Smith
- Provider
- provider Renato Bahringer
- Care site
- care site TWIN CITIES MEDICAL CLINIC PC
- Payer
- payer No insurance
Record id
1287b12a-d9e6-c5db-806b-9ade9c89d8e7