Claim total
$1,938.03
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 1997-03-20
- Stop
- 1997-03-20
The parties
- Patient
- patient Dylan Koepp
- Provider
- provider Shani Carroll
- Payer
- payer Humana
Record id
3ab3a2d9-6408-cff5-278a-0ebeb0655444