Claim total
$1,729.31
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1998-04-22
- Stop
- 1998-04-22
The parties
- Patient
- patient Paul Cody Olson
- Provider
- provider Florentino Boehm
- Payer
- payer Humana
Record id
1015e495-9ac0-3c9e-17c1-1b53cafad92a