Claim total
$641.13
base $93.83 · payer covered $491.13
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1974-08-21
- Stop
- 1974-08-21
The parties
- Patient
- patient Cedrick Heath Rosenbaum
- Provider
- provider Joetta Crooks
- Payer
- payer Medicaid
Record id
03eafe4d-23cd-eb61-bb4c-c3bfdba801c8