Claim total
$299.48
base $93.83 · payer covered $299.48
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2025-08-02
- Stop
- 2025-08-02
The parties
- Patient
- patient Marsha Dodie Kuvalis
- Provider
- provider Arnold Crona
- Care site
- care site SAMA HEALTH CARE
- Payer
- payer Medicaid
Record id
062d51e6-50d3-3fdf-afee-0057070ff06c