Claim total
$766.88
base $93.83 · payer covered $766.88
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2006-12-16
- Stop
- 2006-12-16
The parties
- Patient
- patient Bradford Bennie Klein
- Provider
- provider Lowell Blick
- Payer
- payer Medicaid
Record id
01bbe7d1-151b-3eec-66ce-b9ce7a2faa46