Claim total
$641.13
base $93.83 · payer covered $641.13
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-04-11
- Stop
- 2023-04-11
The parties
- Patient
- patient Dannette Tonya Jacobson
- Provider
- provider Nestor Kling
- Payer
- payer Medicaid
Record id
39772979-843a-a410-0f73-4c37ec7ccddc