Claim total
$910.06
base $93.83 · payer covered $760.06
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1968-01-21
- Stop
- 1968-01-21
The parties
- Patient
- patient Lanell Larson
- Provider
- provider Arnold Crona
- Care site
- care site SAMA HEALTH CARE
- Payer
- payer Medicaid
Record id
2a98f89f-76a4-67f9-ecc7-2cf494dadad1