Claim total
$1,151.75
base $93.83 · payer covered $1,051.75
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2026-01-30
- Stop
- 2026-01-30
The parties
- Patient
- patient Danial Hal Lang
- Provider
- provider Barton Eichmann
- Payer
- payer Medicaid
Record id
06067a48-9015-34d7-3131-ce72c3a40f0f