Claim total
$1,291.70
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2004-11-21
- Stop
- 2004-11-21
The parties
- Patient
- patient Ervin Toby VonRueden
- Provider
- provider Amparo Pouros
- Care site
- care site SENTIENT HEALTHCARE, INC.
- Payer
- payer Humana
Record id
05cb9ca9-5092-9c9d-aef5-b01d3b82c762