Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1955-09-26
- Stop
- 1955-09-26
The parties
- Patient
- patient Hugo Lucas Valenzuela
- Provider
- provider Janice Huel
- Payer
- payer Humana
Record id
335171b1-99b5-a5ab-3d77-6938637174e1