Claim total
$767.69
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-04-07
- Stop
- 2023-04-07
The parties
- Patient
- patient Queenie Van Keebler
- Provider
- provider Fatimah Schumm
- Payer
- payer Humana
Record id
046b1f1e-c36f-c080-c445-80a0642f0e3e