Claim total
$979.43
base $93.83 · payer covered $829.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1998-09-20
- Stop
- 1998-09-20
The parties
- Patient
- patient Lonnie Dibbert
- Provider
- provider Renato Bahringer
- Care site
- care site TWIN CITIES MEDICAL CLINIC PC
- Payer
- payer Medicaid
Record id
1a9d77bd-337f-3ffc-5eb3-24fc8c306bd9