Claim total
$988.27
base $93.83 · payer covered $988.27
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2024-06-24
- Stop
- 2024-06-24
The parties
- Patient
- patient Cristy Pamella Moore
- Provider
- provider Ruben Farrell
- Payer
- payer Medicaid
Record id
012588b7-68ba-5ed1-5a30-a6bf8a98891a