Claim total
$775.00
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-06-18
- Stop
- 2018-06-18
The parties
- Patient
- patient Devorah Xiao Zemlak
- Provider
- provider Douglas Will
- Payer
- payer Humana
Record id
2bd68ab8-f54b-97f8-7261-a7ef48c2b25c