Claim total
$1,383.86
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2012-11-25
- Stop
- 2012-11-25
The parties
- Patient
- patient Ulysses Rick Kihn
- Provider
- provider Criselda Bartell
- Payer
- payer Cigna Health
Record id
22b90427-9632-4f64-851b-b241ffe98bf2