Claim total
$1,098.27
base $93.83 · payer covered $998.27
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-10-04
- Stop
- 2018-10-04
The parties
- Patient
- patient Santa Antonina Bernier
- Provider
- provider David Klein
- Payer
- payer Medicaid
Record id
051f1153-ae45-1425-a11b-ffd0f6f2661e