Claim total
$840.41
base $93.83 · payer covered $740.41
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2019-02-06
- Stop
- 2019-02-06
The parties
- Patient
- patient Amanda Rheba Mitchell
- Provider
- provider Remona Sanford
- Payer
- payer Medicaid
Record id
0363ed75-83f4-7675-aa14-b5e46ea585fb