Claim total
$641.13
base $93.83 · payer covered $512.90
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2018-01-30
- Stop
- 2018-01-30
The parties
- Patient
- patient Nanci Lourie Rath
- Provider
- provider Samuel Boyle
- Care site
- care site CEDAR RIVERSIDE PEOPLES CENTER
- Payer
- payer UnitedHealthcare
Record id
019cb7db-9e62-def9-1942-a3a79d15c971