Claim total
$1,463.73
base $93.83 · payer covered $1,363.73
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2016-11-08
- Stop
- 2016-11-08
The parties
- Patient
- patient Matt Stanton Brown
- Provider
- provider Erich Schimmel
- Care site
- care site PARKWAY FAMILY PHYSICIANS
- Payer
- payer Medicaid
Record id
04e52287-fbd6-ff57-d0a5-d2a23db98b7d