Claim total
$1,049.08
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1978-10-15
- Stop
- 1978-10-15
The parties
- Patient
- patient Verlene Pamula Daniel
- Provider
- provider Rodrick Moen
- Payer
- payer Humana
Record id
3123ff91-9b13-6c6f-5825-f6917100604c