Claim total
$641.13
base $93.83 · payer covered $641.13
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2024-09-15
- Stop
- 2024-09-15
The parties
- Patient
- patient Milly Susanne Blick
- Provider
- provider Shaunda Ledner
- Payer
- payer Medicaid
Record id
31251599-7078-e241-906a-c38c6e331379