Claim total
$367.43
base $93.83 · payer covered $367.43
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2018-12-02
- Stop
- 2018-12-02
The parties
- Patient
- patient Danyell Anya Gislason
- Provider
- provider Phylis Lind
- Payer
- payer Medicaid
Record id
00b8faa9-dae2-fa2d-369f-0b69b40f0afb