Claim total
$980.65
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-02-20
- Stop
- 2018-02-21
The parties
- Patient
- patient Chia Jalisa Champlin
- Provider
- provider Nestor Kling
- Payer
- payer Aetna
Record id
03f9d33d-12ca-f1a8-ebb8-d3fda8ab0408