Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-04-15
- Stop
- 2024-04-15
The parties
- Patient
- patient Leif Darren West
- Provider
- provider Ursula Nolan
- Payer
- payer Humana
Record id
04bc601b-5b17-3710-4e48-6e0e30a4e5ba