Claim total
$777.13
base $93.83 · payer covered $677.13
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2023-11-21
- Stop
- 2023-11-21
The parties
- Patient
- patient Evangeline Kasha Schaden
- Provider
- provider Rodrick Willms
- Care site
- care site CENTRAL FAMILY CLINIC PLLC
- Payer
- payer Medicaid
Record id
0632026e-bab4-0d77-fb69-d365eb73dc0e