Claim total
$1,017.70
base $93.83 · payer covered $917.70
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2025-08-16
- Stop
- 2025-08-16
The parties
- Patient
- patient Breanne Pennie Sawayn
- Provider
- provider Phylis Lind
- Payer
- payer Medicaid
Record id
0db4a798-0c32-fd1c-ff37-5f0618d15a72