Claim total
$941.97
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1998-12-18
- Stop
- 1998-12-18
The parties
- Patient
- patient Queenie Van Keebler
- Provider
- provider Sherwood Nicolas
- Payer
- payer Humana
Record id
046b1f1e-c36f-c080-7698-d1332897a4ee