Claim total
$843.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1974-01-12
- Stop
- 1974-01-12
The parties
- Patient
- patient Cyndy Thora Hackett
- Provider
- provider Tennille Baumbach
- Care site
- care site STONEBRIDGE WELLNESS LTD
- Payer
- payer Humana
Record id
3a6342ed-106b-b99c-6dc8-465622cf8f6c