Claim total
$978.26
base $155.66 · payer covered $978.26
The visit
- Class
- Ambulatory
- Code
- 169762003
- Reason
- —
- Start
- 2019-05-04
- Stop
- 2019-05-04
The parties
- Patient
- patient Dora Violet Okuneva
- Provider
- provider Liz Kozey
- Payer
- payer Cigna Health
Record id
001727b6-dbde-2493-8951-2a5a8c460bfb