Claim total
$498.76
base $93.83 · payer covered $398.76
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2024-06-13
- Stop
- 2024-06-13
The parties
- Patient
- patient Demetrius Fabian Fahey
- Provider
- provider David Klein
- Payer
- payer Medicaid
Record id
011d229d-4683-9f9e-a240-1542bc024438