Claim total
$1,252.07
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-01-02
- Stop
- 2018-01-02
The parties
- Patient
- patient Jamie Alden Murray
- Provider
- provider Sook Smith
- Care site
- care site WELLNESS WAY BLOOMINGTON LLC
- Payer
- payer Humana
Record id
397ff46a-d315-3590-96cc-93e6ac6e2fb2