Claim total
$1,203.25
base $93.83 · payer covered $239.44
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-07-04
- Stop
- 2021-07-04
The parties
- Patient
- patient Titus Robin Padberg
- Provider
- provider Shani Carroll
- Payer
- payer Anthem
Record id
37c88daa-2e1a-b14a-344e-5b13550a3bd8