Claim total
$1,182.06
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2006-11-26
- Stop
- 2006-11-26
The parties
- Patient
- patient Dale Kelly Heller
- Provider
- provider Long Konopelski
- Care site
- care site SAMA HEALTH CARE
- Payer
- payer Cigna Health
Record id
1b3472b4-114e-197d-4210-4f40ef4b71c2