Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2012-12-10
- Stop
- 2012-12-10
The parties
- Patient
- patient Aubrey Mattie Turcotte
- Provider
- provider Jared Berge
- Payer
- payer Humana
Record id
01ad68d8-96ec-fcdf-e8bd-682bfd21debe