Claim total
$1,251.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2013-09-22
- Stop
- 2013-09-22
The parties
- Patient
- patient Ebonie Harris
- Provider
- provider Nenita Glover
- Care site
- care site CENTRAL FAMILY CLINIC PLLC
- Payer
- payer Humana
Record id
2480865a-bd42-7445-500c-551704d0d9f1