Claim total
$229.83
base $93.83 · payer covered $129.83
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2016-10-30
- Stop
- 2016-10-30
The parties
- Patient
- patient Margo Green
- Provider
- provider Brandi Kessler
- Payer
- payer Medicaid
Record id
029fe5e1-f60c-f237-7181-e53da3d0fd97