Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-05-31
- Stop
- 2018-05-31
The parties
- Patient
- patient Michal Andrew Champlin
- Provider
- provider Phylis Lind
- Payer
- payer Humana
Record id
01866125-a841-a217-2112-d47bc3240b18