Claim total
$701.11
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2024-10-24
- Stop
- 2024-10-24
The parties
- Patient
- patient Philip Randy Moen
- Provider
- provider Bret Von
- Payer
- payer Humana
Record id
1697e323-d45f-10d3-b9a1-53ae0fdd8f67