Claim total
$1,241.85
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2012-10-18
- Stop
- 2012-10-18
The parties
- Patient
- patient Delmar Hane
- Provider
- provider Wesley Nader
- Payer
- payer Aetna
Record id
3a738417-6d7e-6b44-4f97-fae01ef94b33