Claim total
$641.13
base $93.83 · payer covered $641.13
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2025-12-18
- Stop
- 2025-12-18
The parties
- Patient
- patient Royce Peter Wolf
- Provider
- provider Emilia Wunsch
- Payer
- payer Dual Eligible
Record id
04658673-6112-6940-6712-46a63c178d77