Claim total
$775.00
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2007-11-04
- Stop
- 2007-11-04
The parties
- Patient
- patient Brendan Kasey Hettinger
- Provider
- provider Donald Ferry
- Care site
- care site WRIGHT MEDICAL CARE PLLC
- Payer
- payer Humana
Record id
0d09b896-2873-86dc-1ba6-147ad2661965