Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2016-01-01
- Stop
- 2016-01-01
The parties
- Patient
- patient Cristina Caridad Salcedo
- Provider
- provider Remona Sanford
- Payer
- payer Humana
Record id
031e24ca-9978-b353-3b51-5f921f74ad5f