Claim total
$711.72
base $93.83 · payer covered $569.37
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-11-06
- Stop
- 2018-11-06
The parties
- Patient
- patient Jared Lenard Hansen
- Provider
- provider Ronnie Gleason
- Payer
- payer Anthem
Record id
047ee4ec-c50b-b504-dacf-7e1fcdba1a64