Claim total
$846.78
base $93.83 · payer covered $746.78
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2021-04-03
- Stop
- 2021-04-03
The parties
- Patient
- patient Zachery Vincenzo Berge
- Provider
- provider Rodrick Moen
- Payer
- payer Medicaid
Record id
01ce818c-8f9f-924a-84b0-6e9e92cef644