Claim total
$840.41
base $93.83 · payer covered $840.41
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2015-11-13
- Stop
- 2015-11-13
The parties
- Patient
- patient Bryan Emmerich
- Provider
- provider Elisha Hyatt
- Payer
- payer Medicaid
Record id
06c81a77-06de-31ce-7ca5-46d0ebbc8ccb