Claim total
$293.11
base $93.83 · payer covered $193.11
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2024-04-14
- Stop
- 2024-04-14
The parties
- Patient
- patient Abdul Sammie Spencer
- Provider
- provider Trent Kozey
- Payer
- payer Medicaid
Record id
009b9fb1-8515-f33d-4d13-fc9252dcefc7