Claim total
$979.48
base $93.83 · payer covered $879.48
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2024-12-23
- Stop
- 2024-12-23
The parties
- Patient
- patient Cristy Pamella Moore
- Provider
- provider Fatimah Schumm
- Payer
- payer Medicaid
Record id
012588b7-68ba-5ed1-81d4-fc37f2e33b04