Claim total
$1,148.85
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-10-20
- Stop
- 2015-10-20
The parties
- Patient
- patient Jared Lenard Hansen
- Provider
- provider Ronnie Gleason
- Payer
- payer Anthem
Record id
047ee4ec-c50b-b504-91bf-65d789b2b794