Claim total
$979.48
base $93.83 · payer covered $979.48
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2024-09-19
- Stop
- 2024-09-19
The parties
- Patient
- patient Demetrius Fabian Fahey
- Provider
- provider David Klein
- Payer
- payer Medicaid
Record id
011d229d-4683-9f9e-4c35-9dfdd8d3e17d