Claim total
$772.84
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1989-12-08
- Stop
- 1989-12-08
The parties
- Patient
- patient Queenie Van Keebler
- Provider
- provider Fatimah Schumm
- Payer
- payer Humana
Record id
046b1f1e-c36f-c080-a977-f0d50ba11e6c