Claim total
$973.34
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-04-12
- Stop
- 2024-04-12
The parties
- Patient
- patient Queenie Van Keebler
- Provider
- provider Ruben Farrell
- Payer
- payer Humana
Record id
046b1f1e-c36f-c080-2d23-1c57d598c67d