Claim total
$694.97
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2011-10-28
- Stop
- 2011-10-28
The parties
- Patient
- patient Josh Monahan
- Provider
- provider Jared Berge
- Payer
- payer Cigna Health
Record id
03f57d95-a536-8def-9b05-eda6235bd6d1