Claim total
$911.00
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2022-02-24
- Stop
- 2022-02-24
The parties
- Patient
- patient Allen Trent Mann
- Provider
- provider Lowell Blick
- Payer
- payer Humana
Record id
007bcc47-8ca5-7eab-0c86-bc3ae53ada6e