Claim total
$911.00
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2012-02-02
- Stop
- 2012-02-02
The parties
- Patient
- patient Hilario Thad Orn
- Provider
- provider Venita Fahey
- Care site
- care site STONEBRIDGE WELLNESS LTD
- Payer
- payer Cigna Health
Record id
27964ba9-ad2a-94be-52e0-d2787f093759