Claim total
$838.28
base $93.83 · payer covered $738.28
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2019-02-01
- Stop
- 2019-02-01
The parties
- Patient
- patient Danial Hal Lang
- Provider
- provider Barton Eichmann
- Payer
- payer Medicaid
Record id
06067a48-9015-34d7-f658-19238cc6aa85