Claim total
$910.06
base $93.83 · payer covered $810.06
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2023-12-10
- Stop
- 2023-12-10
The parties
- Patient
- patient Danyell Anya Gislason
- Provider
- provider Florentino Boehm
- Payer
- payer Medicaid
Record id
00b8faa9-dae2-fa2d-b32d-420c19f35865