Claim total
$1,053.59
base $93.83 · payer covered $1,053.59
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1946-07-24
- Stop
- 1946-07-24
The parties
- Patient
- patient Jami Helen Wisoky
- Provider
- provider Randee Sawayn
- Payer
- payer Humana
Record id
24dd8ac8-6bcb-597c-61d9-21a4e4ec9a10