Claim total
$767.69
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-09-12
- Stop
- 2018-09-12
The parties
- Patient
- patient Tim Taylor Terry
- Provider
- provider Criselda Bartell
- Payer
- payer Humana
Record id
03607fcd-7c51-41c0-46f2-94cf2c8bb798