Claim total
$1,315.67
base $93.83 · payer covered $875.96
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2013-10-09
- Stop
- 2013-10-09
The parties
- Patient
- patient Shon Cesar Ebert
- Provider
- provider David Klein
- Payer
- payer Medicare
Record id
03d8f92f-53db-d7af-1bdb-c367f87564b4