Claim total
$773.83
base $93.83 · payer covered $773.83
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2018-04-01
- Stop
- 2018-04-01
The parties
- Patient
- patient Danyell Anya Gislason
- Provider
- provider Phylis Lind
- Payer
- payer Medicaid
Record id
00b8faa9-dae2-fa2d-808c-ee384d311ff3