Claim total
$293.11
base $93.83 · payer covered $258.11
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1979-07-06
- Stop
- 1979-07-06
The parties
- Patient
- patient Moshe Danilo Schoen
- Provider
- provider Mike Monahan
- Care site
- care site THE FAMILY PARTNERSHIP
- Payer
- payer Dual Eligible
Record id
12e72ee6-8b43-3f6b-fdea-79e09a45dd75