Claim total
$1,457.08
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-06-13
- Stop
- 2015-06-13
The parties
- Patient
- patient Louis Lowe
- Provider
- provider Maryjane Farrell
- Payer
- payer Humana
Record id
0133e229-9af3-5afb-46c2-dc7ccefe6aea