Claim total
$229.83
base $93.83 · payer covered $137.90
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2018-05-21
- Stop
- 2018-05-21
The parties
- Patient
- patient Phylis Elenora Cassin
- Provider
- provider Abram Ullrich
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer Humana
Record id
0400c40b-e8b5-c779-2cc5-727766314ce2