Claim total
$1,174.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-05-08
- Stop
- 2023-05-08
The parties
- Patient
- patient Adam Jones
- Provider
- provider Long Konopelski
- Care site
- care site SAMA HEALTH CARE
- Payer
- payer Cigna Health
Record id
00229130-e769-8779-25b3-9db9a33b25a6