Claim total
$1,729.31
base $93.83 · payer covered $1,579.31
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1986-11-02
- Stop
- 1986-11-02
The parties
- Patient
- patient Josef Earle Cronin
- Provider
- provider David Klein
- Payer
- payer Medicaid
Record id
26c58ea5-e054-be2d-8f74-95ea393804bf