Claim total
$979.43
base $93.83 · payer covered $979.43
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2008-12-04
- Stop
- 2008-12-04
The parties
- Patient
- patient Jonas Raymond Haley
- Provider
- provider David Klein
- Payer
- payer Medicaid
Record id
2e07b33a-27a0-451d-21f8-aa32cff9f265