Claim total
$772.84
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2010-11-25
- Stop
- 2010-11-25
The parties
- Patient
- patient Christy Yaeko Ernser
- Provider
- provider David Klein
- Payer
- payer Anthem
Record id
13d69f71-e09f-b5dc-31b4-c8ed2ae56525