Claim total
$775.00
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-02-01
- Stop
- 2018-02-01
The parties
- Patient
- patient Dylan Koepp
- Provider
- provider Lizeth Schiller
- Payer
- payer Humana
Record id
3ab3a2d9-6408-cff5-22d1-4e38681c51f5