Claim total
$1,527.01
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-11-14
- Stop
- 2025-11-14
The parties
- Patient
- patient Marilynn Jaimie Pouros
- Provider
- provider Rodrick Moen
- Payer
- payer Humana
Record id
0126af27-a469-d3f6-c73a-d8d3ba57ab48