Claim total
$1,108.12
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1992-06-17
- Stop
- 1992-06-17
The parties
- Patient
- patient Jone Rae Hilpert
- Provider
- provider Jared Berge
- Payer
- payer Humana
Record id
06668488-9bc5-0bda-ce5c-e34e5b1f570c