Claim total
$694.97
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-12-22
- Stop
- 2014-12-22
The parties
- Patient
- patient Aubrey Mattie Turcotte
- Provider
- provider Anneliese Bradtke
- Payer
- payer Humana
Record id
01ad68d8-96ec-fcdf-46ff-3e3ce1115f0f