Claim total
$964.84
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2013-12-16
- Stop
- 2013-12-16
The parties
- Patient
- patient Aubrey Mattie Turcotte
- Provider
- provider Jared Berge
- Payer
- payer Humana
Record id
01ad68d8-96ec-fcdf-d100-0663024feb99