Claim total
$777.13
base $93.83 · payer covered $677.13
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2018-08-04
- Stop
- 2018-08-04
The parties
- Patient
- patient Barry Adam Heller
- Provider
- provider Ruben Farrell
- Payer
- payer Medicaid
Record id
02680c28-26cc-4bca-ecaf-d9a23874034c