Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2014-10-04
- Stop
- 2014-10-04
The parties
- Patient
- patient Terrell Doyle Heller
- Provider
- provider Ian Ryan
- Care site
- care site NORTH MEMORIAL HEALTH CARE
- Payer
- payer Humana
Record id
0638f9ad-338f-7ad3-b4d1-427a54f1da0a