Claim total
$979.43
base $93.83 · payer covered $979.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-02-11
- Stop
- 2021-02-11
The parties
- Patient
- patient Will Kris
- Provider
- provider David Klein
- Payer
- payer Medicaid
Record id
0b248530-a284-d3a0-dd5d-c20ccac9e097