Claim total
$505.13
base $93.83 · payer covered $405.13
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2020-02-12
- Stop
- 2020-02-12
The parties
- Patient
- patient Amanda Rheba Mitchell
- Provider
- provider Remona Sanford
- Payer
- payer Medicaid
Record id
0363ed75-83f4-7675-a05c-7fb954d83212