Claim total
$1,225.78
base $93.83 · payer covered $795.19
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-10-15
- Stop
- 2014-10-15
The parties
- Patient
- patient Shon Cesar Ebert
- Provider
- provider David Klein
- Payer
- payer Medicare
Record id
03d8f92f-53db-d7af-828c-00ae851925bd