Claim total
$1,869.60
base $93.83 · payer covered $329.28
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-10-14
- Stop
- 2014-10-14
The parties
- Patient
- patient Jared Lenard Hansen
- Provider
- provider Ronnie Gleason
- Payer
- payer Anthem
Record id
047ee4ec-c50b-b504-257b-fc5a9285d14b