Claim total
$93.83
base $93.83 · payer covered $93.83
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2025-05-22
- Stop
- 2025-05-22
The parties
- Patient
- patient Demetrius Fabian Fahey
- Provider
- provider Magen Mertz
- Payer
- payer Medicaid
Record id
011d229d-4683-9f9e-160e-1fcff2ca92e1