Claim total
$1,023.79
base $93.83 · payer covered $973.79
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2000-01-05
- Stop
- 2000-01-05
The parties
- Patient
- patient Angle Rosalina Okuneva
- Provider
- provider David Klein
- Payer
- payer Medicaid
Record id
0190d3b1-c50c-bf7b-2053-5582ced1a7be