Claim total
$836.12
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2025-04-20
- Stop
- 2025-04-20
The parties
- Patient
- patient Dung Letha Wiegand
- Provider
- provider Shenna Metz
- Care site
- care site CENTRAL FAMILY CLINIC PLLC
- Payer
- payer Cigna Health
Record id
375938f9-6f2b-c55d-02da-c959d4c303e5