Claim total
$838.28
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-09-22
- Stop
- 2021-09-22
The parties
- Patient
- patient Keira Tona Smith
- Provider
- provider Tennille Baumbach
- Care site
- care site STONEBRIDGE WELLNESS LTD
- Payer
- payer Aetna
Record id
2ee18a5a-7976-7950-bca1-1f46aff50232