Claim total
$917.37
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1981-10-18
- Stop
- 1981-10-18
The parties
- Patient
- patient Verlene Pamula Daniel
- Provider
- provider Ursula Nolan
- Payer
- payer Humana
Record id
3123ff91-9b13-6c6f-cb34-4182b00acc32