Claim total
$1,294.74
base $93.83 · payer covered $1,194.74
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2020-11-22
- Stop
- 2020-11-22
The parties
- Patient
- patient Margo Green
- Provider
- provider Pearly Rohan
- Payer
- payer Medicaid
Record id
029fe5e1-f60c-f237-0ea7-9cf77f6cd4db