Claim total
$1,387.39
base $93.83 · payer covered $1,287.39
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2020-03-28
- Stop
- 2020-03-28
The parties
- Patient
- patient Zachery Vincenzo Berge
- Provider
- provider Bret Von
- Payer
- payer Medicaid
Record id
01ce818c-8f9f-924a-7dcc-276ef63b5ded