Claim total
$1,128.87
base $93.83 · payer covered $978.87
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1979-10-18
- Stop
- 1979-10-18
The parties
- Patient
- patient Santa Antonina Bernier
- Provider
- provider David Klein
- Payer
- payer Medicaid
Record id
051f1153-ae45-1425-ed6a-5480b9870fcc