Claim total
$229.83
base $93.83 · payer covered $129.83
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2009-12-16
- Stop
- 2009-12-16
The parties
- Patient
- patient Amanda Rheba Mitchell
- Provider
- provider Emilia Wunsch
- Payer
- payer Medicaid
Record id
0363ed75-83f4-7675-e5ac-bca62098431d