Claim total
$973.34
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2006-12-02
- Stop
- 2006-12-02
The parties
- Patient
- patient Kazuko Tamie Tillman
- Provider
- provider Samuel Boyle
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer Cigna Health
Record id
3487d097-833b-5fcf-df46-d42d1a2fa448