Claim total
$641.13
base $93.83 · payer covered $541.13
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2018-01-31
- Stop
- 2018-01-31
The parties
- Patient
- patient Amanda Rheba Mitchell
- Provider
- provider Magen Mertz
- Payer
- payer Medicaid
Record id
0363ed75-83f4-7675-17aa-3e2779f1cd91