Claim total
$846.78
base $93.83 · payer covered $746.78
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2017-01-14
- Stop
- 2017-01-14
The parties
- Patient
- patient Harry Will Streich
- Provider
- provider David Klein
- Payer
- payer Medicaid
Record id
0399299d-024a-c139-f0a1-e354e64d4941