Claim total
$1,179.29
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-04-23
- Stop
- 2018-04-23
The parties
- Patient
- patient Adam Jones
- Provider
- provider Arnold Crona
- Care site
- care site SAMA HEALTH CARE
- Payer
- payer Anthem
Record id
00229130-e769-8779-c8e7-eb7a084c868e