Claim total
$910.06
base $93.83 · payer covered $760.06
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1978-12-14
- Stop
- 1978-12-14
The parties
- Patient
- patient Marya Laronda Hand
- Provider
- provider Bret Von
- Payer
- payer Medicaid
Record id
23751e2f-eb63-35d9-75f8-371e45212028