Claim total
$755.48
base $93.83 · payer covered $655.48
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2019-11-17
- Stop
- 2019-11-17
The parties
- Patient
- patient Margo Green
- Provider
- provider Brandi Kessler
- Payer
- payer Medicaid
Record id
029fe5e1-f60c-f237-0c3d-f8d9938ba6ad