Claim total
$846.78
base $93.83 · payer covered $746.78
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2020-03-24
- Stop
- 2020-03-24
The parties
- Patient
- patient An Wenona Rau
- Provider
- provider Simon Tremblay
- Payer
- payer Medicaid
Record id
04682680-f77d-0a00-f7a2-4befffe74681