Claim total
$1,121.44
base $93.83 · payer covered $1,021.44
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2023-04-09
- Stop
- 2023-04-09
The parties
- Patient
- patient Abdul Sammie Spencer
- Provider
- provider Trent Kozey
- Payer
- payer Medicaid
Record id
009b9fb1-8515-f33d-f501-2589a8b5a03e