Claim total
$641.13
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-05-19
- Stop
- 2025-05-19
The parties
- Patient
- patient Adam Jones
- Provider
- provider Sage Schiller
- Care site
- care site SAMA HEALTH CARE
- Payer
- payer Cigna Health
Record id
00229130-e769-8779-f518-8584e5202e9d