Claim total
$1,597.60
base $93.83 · payer covered $111.68
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2016-10-25
- Stop
- 2016-10-25
The parties
- Patient
- patient Jared Lenard Hansen
- Provider
- provider Douglas Will
- Payer
- payer Anthem
Record id
047ee4ec-c50b-b504-ebdb-8b691b577aff