Claim total
$846.78
base $93.83 · payer covered $0.00
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-08-05
- Stop
- 2015-08-05
The parties
- Patient
- patient Cassie Kristina Hoeger
- Provider
- provider Donald Ferry
- Care site
- care site WRIGHT MEDICAL CARE PLLC
- Payer
- payer UnitedHealthcare
Record id
0071794d-67c4-c06b-3f5a-8ae5ce9665a8