Claim total
$775.00
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1967-05-26
- Stop
- 1967-05-26
The parties
- Patient
- patient Quinn Maximo Hartmann
- Provider
- provider Kelvin Reichel
- Payer
- payer Humana
Record id
262dbc34-d670-c004-1e92-87ea22dde54f