Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2012-05-06
- Stop
- 2012-05-06
The parties
- Patient
- patient Xuan Collier
- Provider
- provider Shani Carroll
- Payer
- payer Humana
Record id
002d4429-df26-5797-e64f-d64287042d1b