Claim total
$773.83
base $93.83 · payer covered $773.83
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2018-11-05
- Stop
- 2018-11-05
The parties
- Patient
- patient Coretta Philomena Boyle
- Provider
- provider Trent Kozey
- Payer
- payer Medicaid
Record id
06293262-0c72-c029-d78a-ff1f7ee50e88