Claim total
$1,251.43
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2022-04-06
- Stop
- 2022-04-06
The parties
- Patient
- patient Caleb Ted Hilll
- Provider
- provider Venita Fahey
- Care site
- care site STONEBRIDGE WELLNESS LTD
- Payer
- payer Anthem
Record id
36c52f95-f5b0-b5d2-0f07-a35e894171c9