Claim total
$19,108.30
base $93.83 · payer covered $8,727.81
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-04-07
- Stop
- 2015-04-07
The parties
- Patient
- patient Korey Lester Williamson
- Provider
- provider Brenda Moore
- Payer
- payer Humana
Record id
02695016-2813-6239-f811-8840aa86a30d