Claim total
$704.41
base $93.83 · payer covered $704.41
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2024-12-12
- Stop
- 2024-12-12
The parties
- Patient
- patient Royce Peter Wolf
- Provider
- provider Emilia Wunsch
- Payer
- payer Medicaid
Record id
04658673-6112-6940-78b8-11a5f7dfc9fb