Claim total
$1,596.43
base $93.83 · payer covered $1,496.43
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2023-07-10
- Stop
- 2023-07-10
The parties
- Patient
- patient Coretta Philomena Boyle
- Provider
- provider Randee Sawayn
- Payer
- payer Medicaid
Record id
06293262-0c72-c029-4075-18ac2c78917a