Claim total
$767.69
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2022-11-29
- Stop
- 2022-11-29
The parties
- Patient
- patient Jared Lenard Hansen
- Provider
- provider Ronnie Gleason
- Payer
- payer Aetna
Record id
047ee4ec-c50b-b504-9f3f-81497f245246