Claim total
$1,258.56
base $93.83 · payer covered $1,258.56
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2025-02-20
- Stop
- 2025-02-20
The parties
- Patient
- patient Demetrius Fabian Fahey
- Provider
- provider Wesley Nader
- Payer
- payer Medicaid
Record id
011d229d-4683-9f9e-e3ba-f9e75f5b7402