Claim total
$906.71
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2009-05-24
- Stop
- 2009-05-24
The parties
- Patient
- patient Trudy Olene Boyle
- Provider
- provider Trent Kozey
- Payer
- payer Anthem
Record id
224e317b-5fe3-18df-5745-92bfd95b05d2