Claim total
$1,046.06
base $93.83 · payer covered $946.06
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2021-03-30
- Stop
- 2021-03-30
The parties
- Patient
- patient An Wenona Rau
- Provider
- provider Julene Lemke
- Payer
- payer Medicaid
Record id
04682680-f77d-0a00-4444-f90f1bb44d33