Claim total
$985.80
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2013-10-24
- Stop
- 2013-10-24
The parties
- Patient
- patient Delmar Hane
- Provider
- provider Remona Sanford
- Payer
- payer Anthem
Record id
3a738417-6d7e-6b44-8aac-bac76cd403f7