Claim total
$1,210.16
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-08-23
- Stop
- 2016-08-23
The parties
- Patient
- patient Matthew Otis Herman
- Provider
- provider Amparo Pouros
- Care site
- care site SENTIENT HEALTHCARE, INC.
- Payer
- payer Aetna
Record id
3501ea6b-13e3-1b87-56cb-c499fa57f562