Claim total
$704.41
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2020-11-17
- Stop
- 2020-11-17
The parties
- Patient
- patient Jared Lenard Hansen
- Provider
- provider Douglas Will
- Payer
- payer Cigna Health
Record id
047ee4ec-c50b-b504-ab5c-3c1427cdf5e9