Claim total
$840.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2019-10-14
- Stop
- 2019-10-14
The parties
- Patient
- patient Luana Ilana Effertz
- Provider
- provider Florentino Boehm
- Payer
- payer Humana
Record id
086bd61a-213a-915b-21cf-6d29e51db33d