Claim total
$780.15
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-06-12
- Stop
- 2025-06-12
The parties
- Patient
- patient Ezra Byron Schaden
- Provider
- provider Jared Berge
- Payer
- payer Humana
Record id
34aa3e64-c42a-515e-0ed4-e32538b54802