Claim total
$811.24
base $93.83 · payer covered $811.24
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2026-03-23
- Stop
- 2026-03-23
The parties
- Patient
- patient Cristy Pamella Moore
- Provider
- provider Sherwood Nicolas
- Payer
- payer Medicaid
Record id
012588b7-68ba-5ed1-1f49-932425cbd972