Claim total
$1,295.63
base $93.83 · payer covered $1,295.63
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-11-13
- Stop
- 2025-11-13
The parties
- Patient
- patient Santa Antonina Bernier
- Provider
- provider David Klein
- Payer
- payer Medicaid
Record id
051f1153-ae45-1425-4341-df3c1a382c7b