Claim total
$1,111.67
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2007-04-26
- Stop
- 2007-04-26
The parties
- Patient
- patient Allen Trent Mann
- Provider
- provider Julene Lemke
- Payer
- payer Humana
Record id
007bcc47-8ca5-7eab-5d23-6c16826b6307