Claim total
$1,109.34
base $93.83 · payer covered $1,009.34
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-01-13
- Stop
- 2023-01-13
The parties
- Patient
- patient Danial Hal Lang
- Provider
- provider Sang Bernier
- Payer
- payer Medicaid
Record id
06067a48-9015-34d7-aede-9ea321d4726e