Claim total
$1,553.03
base $93.83 · payer covered $1,553.03
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2019-10-07
- Stop
- 2019-10-07
The parties
- Patient
- patient Coretta Philomena Boyle
- Provider
- provider Randee Sawayn
- Payer
- payer Medicaid
Record id
06293262-0c72-c029-3a20-e2cf2a33f6fa