Claim total
$641.13
base $93.83 · payer covered $491.13
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 1973-09-13
- Stop
- 1973-09-13
The parties
- Patient
- patient Santa Antonina Bernier
- Provider
- provider David Klein
- Payer
- payer Medicaid
Record id
051f1153-ae45-1425-cd0a-2109a833a6e0