Claim total
$13,695.38
base $93.83 · payer covered $9,789.90
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2006-07-26
- Stop
- 2006-07-26
The parties
- Patient
- patient Elliot Gottlieb
- Provider
- provider Jayme Rempel
- Care site
- care site LIFE LINE COMMUNITY HEALTHCARE
- Payer
- payer Anthem
Record id
18bccce9-570b-f6f7-3c2c-06add807db55