Claim total
$777.13
base $93.83 · payer covered $677.13
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2017-03-07
- Stop
- 2017-03-07
The parties
- Patient
- patient An Wenona Rau
- Provider
- provider Jared Berge
- Payer
- payer Medicaid
Record id
04682680-f77d-0a00-9225-bf65ac6c3ee5