Claim total
$850.74
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1985-08-14
- Stop
- 1985-08-14
The parties
- Patient
- patient Issac Jackson Gutmann
- Provider
- provider Nenita Glover
- Care site
- care site CENTRAL FAMILY CLINIC PLLC
- Payer
- payer Humana
Record id
2341e99a-66f7-3033-c03b-2ab1f5d7b914