Claim total
$641.13
base $93.83 · payer covered $541.13
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2020-05-31
- Stop
- 2020-05-31
The parties
- Patient
- patient Danyell Anya Gislason
- Provider
- provider Florentino Boehm
- Payer
- payer Medicaid
Record id
00b8faa9-dae2-fa2d-8fb6-8cbdbc6dcb55