Claim total
$1,301.76
base $93.83 · payer covered $1,041.39
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-05-28
- Stop
- 2025-05-28
The parties
- Patient
- patient Angle Rosalina Okuneva
- Provider
- provider Remona Sanford
- Payer
- payer Anthem
Record id
0190d3b1-c50c-bf7b-02e4-dd1de098971a