Claim total
$777.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2017-05-08
- Stop
- 2017-05-08
The parties
- Patient
- patient Onie Shannon Borer
- Provider
- provider Shenna Metz
- Care site
- care site CENTRAL FAMILY CLINIC PLLC
- Payer
- payer Cigna Health
Record id
006af299-d813-2b4f-d5dc-d52db466a8d4