Claim total
$1,046.06
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2014-05-22
- Stop
- 2014-05-22
The parties
- Patient
- patient Callie Amada Walker
- Provider
- provider Pearly Rohan
- Payer
- payer Aetna
Record id
299d821a-6e3e-7aed-fced-817c37c125d4