Claim total
$1,343.71
base $93.83 · payer covered $1,243.71
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2006-01-10
- Stop
- 2006-01-10
The parties
- Patient
- patient Chia Jalisa Champlin
- Provider
- provider Nestor Kling
- Payer
- payer Medicaid
Record id
03f9d33d-12ca-f1a8-24cb-f9148d3ed7ae