Claim total
$1,451.51
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2013-11-14
- Stop
- 2013-11-14
The parties
- Patient
- patient Karon Koelpin
- Provider
- provider Tyson Kautzer
- Care site
- care site THE FAMILY PARTNERSHIP
- Payer
- payer Cigna Health
Record id
223d4220-b8bd-0490-22f9-b78d4fe3130b