Claim total
$780.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1983-11-22
- Stop
- 1983-11-22
The parties
- Patient
- patient Gisela Alexander Yost
- Provider
- provider Florentino Boehm
- Payer
- payer Humana
Record id
1a7dfad4-d894-171e-e032-0b0379efa4e2