Claim total
$435.48
base $93.83 · payer covered $435.48
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2019-06-02
- Stop
- 2019-06-02
The parties
- Patient
- patient Danyell Anya Gislason
- Provider
- provider Phylis Lind
- Payer
- payer Medicaid
Record id
00b8faa9-dae2-fa2d-36af-f375793606c8