Claim total
$1,527.01
base $93.83 · payer covered $55.21
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2015-07-05
- Stop
- 2015-07-05
The parties
- Patient
- patient Terrance Derek Mueller
- Provider
- provider Jared Berge
- Payer
- payer UnitedHealthcare
Record id
032e5f12-51a3-9303-a48e-1fc7d1831ceb