Claim total
$936.88
base $93.83 · payer covered $562.14
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2005-11-27
- Stop
- 2005-11-27
The parties
- Patient
- patient Ervin Toby VonRueden
- Provider
- provider Amparo Pouros
- Care site
- care site SENTIENT HEALTHCARE, INC.
- Payer
- payer Humana
Record id
05cb9ca9-5092-9c9d-c8a4-b0c6580734f1