Claim total
$704.41
base $93.83 · payer covered $422.65
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-03-06
- Stop
- 2017-03-06
The parties
- Patient
- patient Leif Darren West
- Provider
- provider Rodrick Moen
- Payer
- payer Humana
Record id
04bc601b-5b17-3710-d3be-c341b2456489