Claim total
$906.71
base $93.83 · payer covered $25.62
The visit
- Class
- Wellness
- Code
- 162673000
- Reason
- —
- Start
- 2021-07-11
- Stop
- 2021-07-11
The parties
- Patient
- patient Terrance Derek Mueller
- Provider
- provider Jared Berge
- Payer
- payer UnitedHealthcare
Record id
032e5f12-51a3-9303-e1cc-84fe632acf2e