Claim total
$13,765.97
base $93.83 · payer covered $10,069.94
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-03-02
- Stop
- 2017-03-02
The parties
- Patient
- patient Hilario Thad Orn
- Provider
- provider Venita Fahey
- Care site
- care site STONEBRIDGE WELLNESS LTD
- Payer
- payer Anthem
Record id
27964ba9-ad2a-94be-fc68-689bcfcf9eec