Claim total
$1,046.06
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2016-10-15
- Stop
- 2016-10-15
The parties
- Patient
- patient Terrell Doyle Heller
- Provider
- provider Altagracia Rippin
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
0638f9ad-338f-7ad3-830b-7f2bd937a65c