Claim total
$704.41
base $93.83 · payer covered $604.41
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-01-27
- Stop
- 2017-01-27
The parties
- Patient
- patient Danial Hal Lang
- Provider
- provider Barton Eichmann
- Payer
- payer Medicaid
Record id
06067a48-9015-34d7-e600-aa1b8c2c4695