Claim total
$1,593.99
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2010-01-07
- Stop
- 2010-01-07
The parties
- Patient
- patient Hosea Reyes Fay
- Provider
- provider Brenda Moore
- Payer
- payer Cigna Health
Record id
1b836216-0e85-6d8a-1dff-c4c68b859664