Claim total
$127.31
base $127.17 · payer covered $89.12
The visit
- Class
- Inpatient
- Code
- 32485007
- Reason
- —
- Start
- 2016-10-12
- Stop
- 2016-10-13
The parties
- Patient
- patient Chia Jalisa Champlin
- Provider
- provider Alene Legros
- Payer
- payer Cigna Health
Record id
03f9d33d-12ca-f1a8-ed4c-6249a302077f