Claim total
$1,112.36
base $93.83 · payer covered $177.06
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2007-02-22
- Stop
- 2007-02-22
The parties
- Patient
- patient Maryland Hermine Ryan
- Provider
- provider Waneta Boyer
- Care site
- care site HENNEPIN COUNTY
- Payer
- payer Anthem
Record id
2594c568-de7d-2084-52cc-1a8233b5c875