Claim total
$980.65
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-07-22
- Stop
- 2018-07-22
The parties
- Patient
- patient Denyse Fadel
- Provider
- provider Shani Carroll
- Payer
- payer Anthem
Record id
048ae427-86b6-6ce9-fb4d-7fb4a7e2e2df