Claim total
$1,142.66
base $93.83 · payer covered $1,142.66
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2007-12-22
- Stop
- 2007-12-22
The parties
- Patient
- patient Bradford Bennie Klein
- Provider
- provider Jared Berge
- Payer
- payer Humana
Record id
01bbe7d1-151b-3eec-def7-cffa70310de3