Claim total
$458.66
base $93.83 · payer covered $458.66
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2026-01-31
- Stop
- 2026-01-31
The parties
- Patient
- patient Marsha Dodie Kuvalis
- Provider
- provider Richard Carter
- Care site
- care site SAMA HEALTH CARE
- Payer
- payer Medicaid
Record id
062d51e6-50d3-3fdf-8cb5-2bdf90c8121d