Claim total
$1,112.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-01-15
- Stop
- 2021-01-15
The parties
- Patient
- patient Cristina Caridad Salcedo
- Provider
- provider David Klein
- Payer
- payer Humana
Record id
031e24ca-9978-b353-54d7-ad3072f49f9a