Claim total
$229.83
base $93.83 · payer covered $229.83
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2018-01-06
- Stop
- 2018-01-06
The parties
- Patient
- patient Tyrone Gerry Nolan
- Provider
- provider In Reichert
- Payer
- payer Medicaid
Record id
0372df5d-1b51-df61-f5f4-351aec304991