Claim total
$966.97
base $93.83 · payer covered $676.89
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-12-01
- Stop
- 2017-12-01
The parties
- Patient
- patient Josh Monahan
- Provider
- provider Simon Tremblay
- Payer
- payer Cigna Health
Record id
03f57d95-a536-8def-5158-373ff7419332