Claim total
$157.11
base $93.83 · payer covered $157.11
The visit
- Class
- Wellness
- Code
- 308646001
- Start
- 2021-02-14
- Stop
- 2021-02-14
The parties
- Patient
- patient Leo Ramon Wolf
- Provider
- provider Jared Berge
- Payer
- payer Aetna
Record id
0132d8d5-6e6e-d90f-19b0-e176c263623d