Claim total
$1,046.06
base $93.83 · payer covered $896.06
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2004-03-26
- Stop
- 2004-03-26
The parties
- Patient
- patient Danial Hal Lang
- Provider
- provider Dixie Huels
- Payer
- payer Medicaid
Record id
06067a48-9015-34d7-26d3-d7808e9c81d4