Claim total
$906.71
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-10-17
- Stop
- 2015-10-17
The parties
- Patient
- patient Henriette Bambi Mayer
- Provider
- provider Nikia Mills
- Payer
- payer Humana
Record id
2027a6d3-dc36-b4dd-c6f0-843ee45c36e7