Claim total
$836.12
base $93.83 · payer covered $736.12
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2007-03-30
- Stop
- 2007-03-30
The parties
- Patient
- patient Danial Hal Lang
- Provider
- provider Dixie Huels
- Payer
- payer Medicaid
Record id
06067a48-9015-34d7-2bd8-10bad5a6347f