Claim total
$772.84
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2017-06-26
- Stop
- 2017-06-26
The parties
- Patient
- patient Shannon Dietrich
- Provider
- provider Janice Huel
- Payer
- payer Cigna Health
Record id
38564dd1-5505-1cf8-5323-3edd03b3b940