Claim total
$711.72
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-03-12
- Stop
- 2018-03-12
The parties
- Patient
- patient Leif Darren West
- Provider
- provider Ursula Nolan
- Payer
- payer Humana
Record id
04bc601b-5b17-3710-62d9-1e9eba80100c