Claim total
$1,185.08
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1995-08-05
- Stop
- 1995-08-05
The parties
- Patient
- patient Douglas Mose Kertzmann
- Provider
- provider Dustin Ernser
- Care site
- care site WSCHS, INC - AGAPE CLINIC
- Payer
- payer Humana
Record id
2a999821-d76f-cf16-36a2-bcf44d4b8263