Claim total
$983.72
base $93.83 · payer covered $883.72
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-01-19
- Stop
- 2024-01-19
The parties
- Patient
- patient Danial Hal Lang
- Provider
- provider Sang Bernier
- Payer
- payer Medicaid
Record id
06067a48-9015-34d7-bd76-1cfaeaded500