Claim total
$365.83
base $93.83 · payer covered $365.83
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2010-04-08
- Stop
- 2010-04-08
The parties
- Patient
- patient Royce Peter Wolf
- Provider
- provider Remona Sanford
- Payer
- payer Dual Eligible
Record id
04658673-6112-6940-57df-09afcd606c90