Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2013-09-12
- Stop
- 2013-09-12
The parties
- Patient
- patient Senaida Carole Miller
- Provider
- provider Shaun Hills
- Care site
- care site STONEBRIDGE WELLNESS LTD
- Payer
- payer Humana
Record id
18b101ed-6582-7193-4aee-1f48cd340e74