Claim total
$773.83
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2016-11-21
- Stop
- 2016-11-21
The parties
- Patient
- patient Phylis Elenora Cassin
- Provider
- provider Luisa Wilkinson
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer Humana
Record id
0400c40b-e8b5-c779-1034-043e272a5681