Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2026-03-05
- Stop
- 2026-03-05
The parties
- Patient
- patient Allen Trent Mann
- Provider
- provider Jared Berge
- Payer
- payer Humana
Record id
007bcc47-8ca5-7eab-ec6f-3040db1fa1ec