Claim total
$1,028.68
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1987-11-09
- Stop
- 1987-11-09
The parties
- Patient
- patient Jaime Howard Spinka
- Provider
- provider Sheldon Graham
- Care site
- care site SAMA HEALTH CARE
- Payer
- payer Humana
Record id
07e284d3-e639-290a-c09c-137eb9e8f6b6