Claim total
$641.13
base $93.83 · payer covered $491.13
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1977-12-12
- Stop
- 1977-12-12
The parties
- Patient
- patient Marlin Renato Heller
- Provider
- provider Julene Lemke
- Payer
- payer Medicaid
Record id
19e6f368-699b-8438-0540-e595f0251dcc