Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-06-12
- Stop
- 2025-06-12
The parties
- Patient
- patient Michal Andrew Champlin
- Provider
- provider Florentino Boehm
- Payer
- payer Humana
Record id
01866125-a841-a217-da6e-5d16c7693b69