Claim total
$773.83
base $93.83 · payer covered $118.81
The visit
- Class
- Wellness
- Code
- 410620009
- Reason
- —
- Start
- 2022-11-04
- Stop
- 2022-11-04
The parties
- Patient
- patient Valentine Spencer Cole
- Provider
- provider Sylvester Bartoletti
- Payer
- payer Anthem
Record id
00a9c741-f837-12c0-720d-7f7a21554bed