Claim total
$980.65
base $93.83 · payer covered $980.65
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2023-12-05
- Stop
- 2023-12-05
The parties
- Patient
- patient Jared Lenard Hansen
- Provider
- provider Ronnie Gleason
- Payer
- payer Aetna
Record id
047ee4ec-c50b-b504-3a40-9e454dba0bfd