Claim total
$641.13
base $93.83 · payer covered $541.13
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2017-01-25
- Stop
- 2017-01-25
The parties
- Patient
- patient Amanda Rheba Mitchell
- Provider
- provider David Klein
- Payer
- payer Medicaid
Record id
0363ed75-83f4-7675-a762-e8f96fa4af58