Claim total
$1,122.96
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-04-18
- Stop
- 2017-04-18
The parties
- Patient
- patient Korey Lester Williamson
- Provider
- provider Austin Roob
- Payer
- payer Humana
Record id
02695016-2813-6239-5fc3-5c2aeea38421