Claim total
$1,463.73
base $93.83 · payer covered $1,313.73
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1984-02-28
- Stop
- 1984-02-28
The parties
- Patient
- patient Chia Jalisa Champlin
- Provider
- provider Nestor Kling
- Payer
- payer Medicaid
Record id
03f9d33d-12ca-f1a8-be58-ad25358e3726