Claim total
$1,258.74
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2024-11-16
- Stop
- 2024-11-16
The parties
- Patient
- patient Elliott Earl Hahn
- Provider
- provider Izola Wuckert
- Payer
- payer Anthem
Record id
0b8f7242-e3ad-86e8-ea24-8e8457a47062