Claim total
$836.12
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1988-11-04
- Stop
- 1988-11-04
The parties
- Patient
- patient Jake Jeremy Osinski
- Provider
- provider Samuel Boyle
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer Humana
Record id
0dfbe012-8ee8-d7ad-05aa-ab57b8406c91