Claim total
$924.68
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-04-10
- Stop
- 2023-04-10
The parties
- Patient
- patient Leif Darren West
- Provider
- provider Rodrick Moen
- Payer
- payer Humana
Record id
04bc601b-5b17-3710-447b-8d1e7d57b04e