Claim total
$775.00
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-05-11
- Stop
- 2021-05-11
The parties
- Patient
- patient Korey Lester Williamson
- Provider
- provider Brenda Moore
- Payer
- payer Humana
Record id
02695016-2813-6239-4306-04051326513e