Claim total
$982.78
base $93.83 · payer covered $882.78
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2018-03-13
- Stop
- 2018-03-13
The parties
- Patient
- patient An Wenona Rau
- Provider
- provider Simon Tremblay
- Payer
- payer Medicaid
Record id
04682680-f77d-0a00-6b8d-9335fa9a045a