Claim total
$536.40
base $93.83 · payer covered $436.40
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2018-07-30
- Stop
- 2018-07-30
The parties
- Patient
- patient Coretta Philomena Boyle
- Provider
- provider Randee Sawayn
- Payer
- payer Medicaid
Record id
06293262-0c72-c029-641f-1c2db02764ab