Claim total
$1,159.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1975-07-05
- Stop
- 1975-07-05
The parties
- Patient
- patient Alan Danny White
- Provider
- provider In Reichert
- Payer
- payer Humana
Record id
0d37fa46-9809-7e01-d243-26bc2e398fe0