Claim total
$980.65
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-04-12
- Stop
- 2017-04-12
The parties
- Patient
- patient Angle Rosalina Okuneva
- Provider
- provider Remona Sanford
- Payer
- payer Aetna
Record id
0190d3b1-c50c-bf7b-8be8-4706b4106395