Claim total
$767.69
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2004-09-30
- Stop
- 2004-10-01
The parties
- Patient
- patient Jerome Kohler
- Provider
- provider Lovie Turcotte
- Payer
- payer Humana
Record id
2feabf77-27d8-4e25-ad23-42b2dd43d51a