Claim total
$1,733.60
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2012-11-06
- Stop
- 2012-11-06
The parties
- Patient
- patient Walton Klocko
- Provider
- provider Sage Schiller
- Care site
- care site SAMA HEALTH CARE
- Payer
- payer Cigna Health
Record id
26c20147-5b5e-d87e-e099-7a962a50de19