Claim total
$450.93
base $93.83 · payer covered $450.93
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2024-09-28
- Stop
- 2024-09-28
The parties
- Patient
- patient Marsha Dodie Kuvalis
- Provider
- provider Arnold Crona
- Care site
- care site SAMA HEALTH CARE
- Payer
- payer Medicaid
Record id
062d51e6-50d3-3fdf-0441-e0746aed353c