Claim total
$772.84
base $93.83 · payer covered $622.84
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1984-05-08
- Stop
- 1984-05-08
The parties
- Patient
- patient Wilfred Dylan Stracke
- Provider
- provider David Klein
- Payer
- payer Medicaid
Record id
12af9e1b-7bdb-0614-b2a9-c0ff0dd8746e