Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-07-08
- Stop
- 2024-07-08
The parties
- Patient
- patient Maricela Howell
- Provider
- provider Ursula Nolan
- Payer
- payer Humana
Record id
3abd9004-9a59-3def-b74b-2e3c054e4217