Claim total
$767.69
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-10-25
- Stop
- 2021-10-25
The parties
- Patient
- patient Jaime Howard Spinka
- Provider
- provider Sage Schiller
- Care site
- care site SAMA HEALTH CARE
- Payer
- payer Humana
Record id
07e284d3-e639-290a-5be7-1e54ac7c8338