Claim total
$1,112.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2026-06-15
- Stop
- 2026-06-15
The parties
- Patient
- patient Onie Shannon Borer
- Provider
- provider Shenna Metz
- Care site
- care site CENTRAL FAMILY CLINIC PLLC
- Payer
- payer Aetna
Record id
006af299-d813-2b4f-84e4-9540288c58c6